DESSEN, MOSES & ROSSITTO

Last Updated: May 28, 2006


INFORMATION ABOUT
WORKERS' COMPENSATION


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.

WHAT IS WORKERS' COMPENSATION?

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.

WHAT SHOULD I DO IF I'M HURT ON THE JOB?

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.

MAY I STILL COLLECT WORKERS' COMPENSATION EVEN IF I CAUSED MY OWN INJURY?

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.

HOW MUCH WORKERS' COMPENSATION WILL I COLLECT?

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.

WHAT HAPPENS IF MY EMPLOYER DENIES MY CLAIM?

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.

WHAT IF MY EMPLOYER WANTS TO END OR MODIFY MY BENEFITS?

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.

WHAT WILL HAPPEN AT THE HEARING?

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.

HOW IS THE CASE DECIDED?

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.

DO I NEED AN ATTORNEY?

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.

WILL MY EMPLOYER BE OFFENDED IF I HIRE AN ATTORNEY?

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.

HOW IS MY ATTORNEY PAID?

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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