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The Workers Compensation Process in Pennsylvania

July 10, 2020

The Pennsylvania’s Workers’ Compensation Act was passed nearly 100 years ago to ensure prompt payment of medical expenses and lost wages to workers injured on the job and to provide death benefits to families of employees killed at work.

Injured workers are supposed to quickly receive benefits, regardless of the employer’s fault for the injury. In fact, under Workers’ Compensation law, you do not have to prove that your employer did anything wrong, only that you were injured in the course of your employment. However, in exchange, you give up your right to sue your employer.

It Should Be Simple, but It Is Not

This arrangement is designed to avoid drawn-out lawsuits and to immediately get injured employees the money they need. Yet, quite often, the employer or insurance carrier contests the payment of benefits.

Pennsylvania law requires all employers to have Workers’ Compensation insurance. Employers who fail to obtain coverage may face lawsuits by injured workers and even criminal prosecution.

You are covered by your employer’s Workers’ Compensation insurance from the first day on the job. You are covered for any injury that occurs within the course and scope of your employment, even if the injury is not known until after your employment is terminated.

While the process seems straightforward, obtaining Pennsylvania Workers’ Compensation benefits can be complex. Very specific rules govern what injured employees, their employers, and the employer’s workers comp insurers must do. But the facts of each Workers’ Comp injury are unique, and the rules that apply may vary. Philadelphia Workers’ Compensation lawyers at E.S. Borjeson & Associates can explain the rules that apply to your case and ensure that you, your employer, and the insurer comply with them.

The Workers’ Compensation Process Generally Works as Follows:

  • You must notify your employer of your injury within 120 days or lose your right to benefits. If you provide notice within 21 days, you are entitled to benefits from the date of the injury. After 21 days, you are entitled to benefits from the date you gave notice.

  • Your employer must immediately notify its insurance carrier of your injury.

  • Your employer must already have a list of medical providers from which you can choose a doctor to treat you for the first 90 days. Your employer cannot tell you which provider to see, nor can it or the insurance carrier have a representative present during your doctor visits. The insurance company can require you to submit to an independent medical evaluation (IME) by one of its doctors, but this is an examination, not treatment, and you have no doctor-patient relationship with the company’s physician.

  • Within 21 days from the date the employer receives notification of injury, the employer/carrier must either accept or deny liability for the injury.

    • If it accepts liability, it issues a Notice of Compensation Payable and begins paying benefits.

    • Alternatively, it could issue a Notice of Temporary Compensation Payable (NTCP). It does not admit liability but begins paying benefits. An insurer can revoke the NTCP within 90 days.

    • If it denies liability, it issues a Notice of Workers’ Compensation Denial to the employee.

  • If the employer denies the claim, you have three years from the date you were injured or should have known you had a work-related injury to file a claim petition with the Bureau of Workers’ Compensation. Workers’ Compensation petitions are normally assigned to a Workers’ Compensation Judge.

  • The judge holds a hearing to hear evidence from you and your employer.

  • The judge renders a decision.

  • The judge’s decision can be appealed to the Workers’ Compensation Appeal Board, Commonwealth Court, and then to the Pennsylvania Supreme Court.

  • A settlement agreement that requires you to release the employer/insurer from further claims must be approved by a Workers’ Compensation Judge who will hold a hearing to ensure you understand the agreement.

Real Worker’s Compensation Help in Pennsylvania

The Philadelphia Workers’ Compensation lawyers at E.S. Borjeson & Associates understand that individuals who have been injured at work often feel that they have no place to turn for help. The employee will often find that the employer does not view the injury in the same way as the victim does. Often, employers try to dodge responsibility for Workers’ Compensation payments because they want to save on insurance premiums, which may go up after an accident. Employers and their insurance companies may not fully comply with Workers’ Comp laws. Only a qualified Pennsylvania Workers’ Compensation lawyer can be certain that your rights are protected.

Contact Our Philadelphia Workers’ Compensation Lawyers Today

Contact the Philadelphia Workers’ Compensation attorneys at E.S. Borjeson & Associates for experienced legal representation with your Workers’ Compensation case. We can guide you through the complex process, explain available benefits, and help ensure you are fully compensated. Call us today or contact us online. Our law offices are conveniently located in Center City, Philadelphia allowing us to serve clients throughout Southeast Pennsylvania, including Bucks County, Delaware County, Chester County, Montgomery County, and Berks County.