If you’ve been in the workforce a long time and suffered an injury on the job, maybe you have a handle on some of the ins and outs of workers’ compensation in Pennsylvania. Most hard-working individuals in the state, though, have never had to confront this complicated system. Even if you have, it can be unwise to presume that your next experience will be the same as your last.

While the law of the state requires employers to provide no-fault workers’ compensation coverage, the statutes do allow for some exceptions. Failure to understand the limitations could leave you ineligible for benefits. Additionally, insurance plans can vary and the administrating companies of the plans have strong incentive to deny benefits if they feel they can do so legally.

In such an environment and acknowledging that employers and insurers have the benefit of skilled legal counsel behind them, it’s even more important for you as an injured workers to have competent counsel at your side.

The intent of this blog post is to provide a brief view of Pennsylvania workers’ compensation law basics. To begin with, it’s important to understand what this insurance is supposed to do.

Workers’ compensation is a compromise of competing interests. Employers agree to provide coverage for nearly any work-related injury or illness, covering medical care, loss of wages, rehabilitation and/or possible retraining. The code also includes death benefits. In most cases, employees who seek workers’ compensation give up the right to sue for personal injury, so maximizing workers’ compensation is crucial.

Employees also face obligations under the law. For example

  • After being injured or becoming ill, you should get immediate care and tell the provider your condition is work-related.
  • You must report the details of the situation to your employer to begin receiving benefits as soon as possible. If you wait more than 120 days, you could be barred from any eligibility.

After those initial steps, your employer’s insurer has 21 days to either deny or approve your claim. If it’s approved, you should begin receiving benefits quickly. If your claim is denied or you dispute the compensation plan, you have three years to seek a hearing before a workers’ compensation judge. If unsatisfied with that outcome, further appeal to the workers’ compensation board may be possible.

With all that is at stake, it’s clear that acting to protect your rights makes sense.