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Workers' Compensation

The Pennsylvania Workers' Compensation Act requires most employers to have workers' compensation insurance to cover their workers' employment-related injuries. These benefits cover workers' lost income and medical expenses. However, the process for obtaining these benefits is not always easy or straightforward.

If you have been injured on the job, you will need an attorney to help ensure that you receive all the workers' compensation benefits that you deserve. Attorney Rick Palazzo is committed to walking with you through the process, answering all your questions and making sure you have a clear picture of how your case will progress. Rick will aggressively pursue your claims to deliver the right result for your needs.

Answers to some questions you might have regarding your work-related injury:

What is workers' compensation?
If you sustain a job injury or a work-related illness, the Pennsylvania Workers' Compensation Act (Act) provides for your medical expenses and, in the event you are unable to work, wage-loss compensation benefits until you're able to go back to work. Additionally, death benefits for work-related deaths are paid to your dependent survivors.

How do I make a claim for benefits?
Prompt reporting is very important. Report any injury or work-related illness to your employer or supervisor immediately as well as to the doctor. You must tell your employer that you were injured in the course of employment and inform your employer of the date and place of injury. Failure to notify the employer can result in the delay or denial of benefits. Once you have lost a day, shift or turn of work, your employer is required to report your injury to the Bureau of Workers' Compensation (bureau) by filing a First Report of Injury.

The employer may choose to either accept or deny the claim. If your claim is denied, you have the right to file a Claim petition with the bureau for a hearing before a WC judge. It is the recommendation of Young and Young that you contact the office for an appointment if your benefits are denied or if you have questions regarding your claim.

What benefits are available to an injured worker?
The law provides several types of workers' compensation benefits:

• Payments For Lost Wages - wage-loss benefits are available if it is determined that you are totally disabled and unable to work or partially disabled and receiving wages less than your pre-injury earnings.
• Death Benefits-if the injury results in death, surviving dependents may be entitled to benefits.
• Specific Loss Benefits - if you have lost the permanent use of all or part of your thumb, finger, hand, arm, leg, foot, toe, sight, hearing, or have a serious and permanent disfigurement on your head, face or neck, you may be entitled to a specific loss benefits.
• Medical Care - employers are required by law to advise workers of their rights and duties. The written notice of these rights and duties is to be provided to the employee at the time of injury or as soon after the injury as is practicable.
• In the event of a work-related illness or injury, you are entitled, if covered under the Act, to the payment of related reasonable surgical and medical services rendered by a physician or other health care provider.
• Medicine, supplies, hospital treatment and services, orthopedic appliances, and prostheses are also covered for as long as they are needed. Even if you have lost no time from work, health care costs for a work-related injury or illness are payable at the fee schedule rate. However, an employee may not be charged the difference between the health care provider's charge and the amount paid by the employer or its insurance carrier.
• Employers are required by law to advise workers of their rights and duties. The written notice of these rights and duties is to be provided to the employee at the time of injury or as soon after the injury as is practicable.

In the event of a work-related illness or injury, you are entitled, if covered under the Act, to the payment of related reasonable surgical and medical services rendered by a physician or other health care provider.
Medicine, supplies, hospital treatment and services, orthopedic appliances, and prostheses are also covered for as long as they are needed. Even if you have lost no time from work, health care costs for a work-related injury or illness are payable at the fee schedule rate. However, an employee may not be charged the difference between the health care provider's charge and the amount paid by the employer or its insurance carrier.

Can I choose my own doctor?

You are free to choose your own doctor unless the employer accepts your claim and has posted a list of six or more physicians or health care providers in your workplace, then you are required to visit one of them for initial treatment. You are to continue treatment with that provider or another on the list for a period of 90 days following the first visit. You may see any provider on the list; your employer may not require or direct you to any specific provider on the list.

If during the 90-day period you visit a provider not on the list, your employer or your employer's insurance carrier may refuse to pay for such treatment. After the 90 days, as well as in situations where your employer has no posted list or an improper list, you may seek treatment with any physician or other health care provider you select. You must notify your employer of the provider you have selected. During treatment, the employer or the employer's insurance carrier is entitled to receive monthly reports from your physician or provider.

Injured workers should be advised that your health care providers may need information concerning your claim. Some of this information may be contained in correspondence you receive from your insurance carrier, and you may want to provide copies of letters or forms to your health care provider.
Once you begin receiving workers' compensation benefits, the employer/insurer has the right to ask you to see a doctor of their choice for examination. If you refuse, the employer is entitled to request an order from a workers' compensation judge requiring you to attend an examination. Failure to then attend after a judge has issued an order may result in a suspension of your benefits.

How much are the payments for lost wages?
Wage-loss benefits are equal to approximately two-thirds of your average weekly wage, up to a weekly maximum. These benefits can be offset for 50% of Social Security "old age" benefits, the employer-paid portion of a retirement pension, severance pay, unemployment compensation or earnings the employee receives. The law does not allow for a cost-of-living increase.

When are wage-loss payments made?
You must be disabled more than seven calendar days (including weekends) before payments for disability are payable. Benefits for time lost from work are payable on the eighth day after injury. Once you have been off work 14 days, you receive retroactive payment for the first seven days.
If you report the injury promptly, miss more than seven days of work and your claim is accepted by the insurance carrier, you should receive your first compensation check within 21 days of your absence from work. After that, you will receive a check on a regular basis.

Payments of temporary compensation may be made by your employer or the insurance carrier for up to 90 days, even if your claim is not accepted by your employer or its insurance carrier. If your employer or their insurance carrier advises you that it will not continue your temporary compensation checks past 90 days, the offices of Young and Young recommend that you call for an appointment to speak with an attorney about your rights.

What if my employer offers me a job while I am recovering from my work injury?
If, after you begin to receive benefits, your employer has evidence to prove that employment is available to you, within your medical restrictions and in your local area, you may receive an offer of employment. You have the right to either accept or decline the job offer.

If you decline, the employer may then petition a workers' compensation judge to either reduce or stop your wage-loss benefits based upon that job. The insurer/employer must continue to pay benefits during the hearing process unless the judge orders otherwise.

In open hearings, the judge will evaluate medical evidence, both from you and your insurer/employer, on the availability of the work and your ability to do it, before rendering a decision.
If your employer offers work to you while you are recovering, the offices of Young and Young strongly recommend that you call for an appointment to speak with an attorney about your rights.

When Will My Wage-Loss Payments Stop?
Wage-loss benefits can be stopped by an employer/insurer who has evidence that you have returned to work at wages equal to or more than your earnings level prior to the injury and after providing a timely notice of that fact. In addition, if you are receiving temporary compensation benefits during the 90 days following the report of injury, the insurance carrier/employer may notify you they are stopping benefits because they are not accepting the claim of a work-related injury.

If you are receiving workers' compensation benefits and the insurance company has advised you that they are stopping payment of those benefits, the offices of Young and Young recommend that you call for an appointment immediately to speak with an attorney about your rights.

What if there is a problem?
The insurance carrier is allowed 21 days from your notice to the employer of your disability to decide to accept or deny your claim or to make payments of temporary compensation for up to 90 days.
If you think you haven't received benefits to which you are entitled, if your claim has been denied, or if the insurance company is trying to stop your ongoing benefits, contact the office of Young and Young for a free consultation.

Workers' Compensation Lump Sum Settlements
If you sustain a work related injury and are receiving workers compensation benefits, you may be entitled to a lump sum settlement. If you would like to discuss whether a lump sum settlement of your workers' compensation benefits would be in your best interests, it is imperative that you speak with an attorney before making your decision.

There are many complex issues involved in a workers' compensation settlement which could be overlooked without proper representation by an experienced attorney.

Rick Palazzo of Young and Young has been handling workers compensation settlements for 25 years. He is adept at negotiating the highest possible amount for his clients and is fully versed in Pennsylvania law so that they are fully protected.

If you are considering whether a settlement of your workers compensation benefits would be right for you, call the offices of Young and Young for a free consultation before speaking with the insurance company.

Free consultation. No recovery, no fee

All workers' compensation cases are handled on a contingency basis. Therefore, we only get paid if we win or prevent the insurance company from stopping or altering your benefits. We have represented workers from diverse industries, with all types of injuries. We want to hear about your case and provide you with the information you need to make the decisions that are right for you.

Call us in Manheim at 717-665-2207, in Leola at 717-656-3388 to schedule a free consultation.

Attorney Richard J. Palazzo emphasizes the practice of workers' compensation law, and is a member of the Million Dollar Advocates Forum.