Last Updated: May 28, 2006
In most states, individuals injured on the job are entitled to collect Workers' Compensation benefits, no matter who caused the accident. In exchange for this guaranteed coverage, most states forbid injured workers from suing their employer for their injuries.
We hope that the questions and answers presented here will assist you in familiarizing yourself with Workers' Compensation issues and terms. While the material below attempts to answer common questions in this area based upon Pennsylvania's Workers' Compensation law, other State and local laws may significantly modify the facts set forth. Because all legal problems are unique, nothing provided here is a substitute for the advice of competent counsel. We strongly urge you to consult with an attorney licensed to practice in your state about any particular legal problem you may have.
Workers'
Compensation is a state mandated program that provides wages and medical
benefits to all workers who have sustained a work-related injury or illness.
Basic benefits include:
· weekly wage payments for as long as you remain disabled;
· payment of all medical, hospital and surgical expenses, so long as they are reasonable, necessary and arise from the work related injury or illness; and
· death benefits and burial expenses to your dependents if you are killed on the job.
These benefits continue until the employee is able to return to work or when the employer files a petition to terminate, suspend or modify benefits. To be eligible for Workers' Compensation, you must be injured during the course and in the scope of your employment and the injury must preclude you from being able to perform some or all of your tasks of employment.
You
should immediately report your injury
to your supervisor and
obtain whatever emergency medical treatment is necessary. You should then fill
out an accident report and any other required documents. If there is no dispute
as to the cause of your injury, you will normally begin to receive your
benefits in a few weeks.
It
does not matter who caused the injury- whether it was your co-worker, your
friend or you, as a result of your own carelessness while you were on the job.
You are still entitled to workers' compensation benefits if your injury
occurred while you were working.
The
amount of workers' compensation benefits you receive is dependent on the
amount of income you made while working. Your check will be for a percentage of
your prior earnings.
In
most states there is an administrative procedure through which you can contest
your employer's denial of benefits. In Pennsylvania this procedure is started
by filing a claim petition with the Bureau of Workers' Compensation, which then
assigns it to a Workers' Compensation judge.
In
Pennsylvania your benefits may be terminated, modified
or suspended if you agree in writing
or as a result of an order by a Workers' Compensation judge. This means that if
you do not agree that you are ready to return to work or otherwise be taken off
compensation benefits, your employer must file a petition to terminate, suspend
or modify your benefits. As in the case of a claim petition, the petition to
terminate, suspend or modify your benefits will be assigned to a Workers'
Compensation judge who will schedule a series of evidentiary hearings.
As
the Claimant, you will testify in person before the
Workers' Compensation
judge. During your testimony, you will have an opportunity to explain how and
when the injury occurred, and why you believe your claim is work-related (if
that is an issue). You will also testify about the medical treatment you
received or are receiving for the injury and your present health as it relates
to your injury or illness.
Usually,
after you have testified, the hearing
will adjourn for the purpose
of taking the deposition testimony of your doctor and a doctor hired by your
employer to examine you. It is not unusual for the two doctors to disagree
about your ability to work. If that occurs, the Workers' Compensation judge
must decide which doctor's testimony is more believable. After all the evidence
has been presented, the judge will prepare a written decision.
You need
an attorney in two situations. First, although you may be legitimately injured
at work or in a work related activity, your employer might still deny your
claim for benefits. Secondly, you may be receiving Workers' Compensation
benefits when your employer decides to terminate, suspend or reduce those
benefits, usually because the employer believes you are more ready to return to
work than you really are. Your employer or its insurance carrier will be
represented by attorneys who frequently represent employers before
Workers' Compensation judges. They are familiar with the Workers' Compensation
system and the medical issues concerning your ability to work. You may be at a
severe disadvantage if you do not have an experienced lawyer representing your
interests.
In
most cases, it is really the Workers' Compensation insurance carrier, not your
employer, who makes the decision regarding whether to contest your claim for
Workers' Compensation benefits, or to attempt to terminate, suspend or modify
those benefits once you are receiving them. Most insurance carriers assume you
will obtain an attorney to help you with your case. Similarly, most employers
recognize the necessity of having an attorney to deal with the insurance
company, its attorneys and the Workers' Compensation system, and are rarely
offended by an employee hiring an attorney to see that he or she receives the
benefits he or she is entitled to under the law.
Workers'
Compensation attorneys are ordinarily paid on a contingency fee basis. This
means that your attorney is paid a percentage of your weekly compensation wage
benefits as permitted by the Workers' Compensation Act. However, the mere
hiring of an attorney does not mean that the attorney will immediately begin
receiving a percentage of your wage benefits. No fee to the attorney is ordinarily
paid until the Workers' Compensation judge permits the attorney to receive a
fee.
If you or someone you know has a Workers' Compensation problem, a DESSEN, MOSES & ROSSITTO attorney will be happy to review the facts of the incident. Just press the button below to submit a factual history form.
If you have other questions or comments about the area of Workers' Compensation or any other area in which we practice, please send us an E-mail message with your questions or comments and we will be happy to try to assist you.
LINKS TO OTHER INTERESTING INFO
Employees Benefits Law
Employees Benefits Research Institute
Occupational Health and Safety Administration
(OSHA)
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