If you’ve sustained an injury while doing your job, the state of Pennsylvania’s workers’ compensation system may help you manage the financial implications. Nearly all employers in Pennsylvania must carry workers’ compensation insurance to cover valid claims from their employees. The few classes of employees not covered by this requirement include government employees, railroad workers and others who fall under different compensation programs.
The workers’ comp basics in this guide apply to most Pennsylvania employees, and knowing these essentials will help you get the benefits you deserve.
How to File for Workers’ Comp in PA
For your workers’ compensation claim to succeed, you must complete all the correct steps on time. Filing for workers’ comp in Pennsylvania involves five steps:
- Seek medical care immediately upon becoming aware of the injury, both for your well-being and as evidence to support your injury claim.
- Report your injury to your employer within 120 days. Reporting the injury immediately after it happens gives you more time to handle any setbacks in the process.
- Check that your employer files a First Report of Injury (FROI) form with the Workers’ Compensation Bureau within seven days of you missing work due to injury.
- Confirm that your employer reports the injury to their insurance carrier right after you inform them about it. The carrier then has 21 days to process the claim.
- Wait for your employer’s carrier to accept or deny your claim. If your claim is accepted, you’re entitled to start receiving benefits as early as eight days after first missing work due to injury.
Appealing a Denied Pennsylvania Workers’ Comp Claim
If your employer neglects or refuses to follow any of the steps above, or if their carrier denies your claim, seek a workers’ comp attorney’s help to appeal and file your claim petition with the Pennsylvania Workers’ Compensation Bureau within three years of becoming aware of the injury. This will start the appeals process in your workers’ compensation case.
An appeal may be necessary to win your case if, for example:
- Your employer disputes the reason for your injury.
- Your employer disputes the severity of your injury.
- Your employer claims you were intoxicated.
- You did not provide enough evidence to support your initial claim.
If the judge decides not to award you compensation, a workers’ comp attorney can advise you on whether your case is worth pursuing further and how to do so for the best chance of success. If you decide to go forward, you can appeal the decision by submitting this form to the Workers’ Compensation Appeal Board within 20 days of the decision.
How Are Pennsylvania Workers’ Comp Benefits Calculated?
Most workers in Pennsylvania can claim up to two-thirds of their weekly salary as wage-loss benefits under the Pennsylvania Workers’ Compensation Act of 1915.
Each year, the Department of Labor and Industry updates the benefit scale used to calculate your workers’ compensation based on statewide average wages. The highest earners receive the maximum payment, which could be less than two-thirds of their weekly pay. The lowest earners can receive 90% of their weekly pay. But workers earning nearer that year’s average wage receive 66.6% of their average weekly pay or a standard rate close to that amount.
PA Workers’ Comp Settlements
In some cases, usually when you’re entitled to workers’ comp benefits extending over a long period, your employer or their insurer may offer you a settlement to resolve your claim. This means both parties agree to a lump sum or structured payment plan other than what the standard workers’ comp benefit schedule would be in your case. You may choose to accept, decline or negotiate this offer. If you choose to accept it, you must get approval from a workers’ compensation judge.
Accepting a workers’ comp settlement could be the right call if:
- You prefer having access to the money now rather than receiving payments over a longer period.
- You’ve reached maximum medical improvement (MMI) and can estimate future medical costs the settlement should cover.
- You no longer want to deal with the insurance company.
- You want to part ways with your employer.
When to Hire a PA Workers’ Comp Lawyer
The best time to hire a workers’ comp lawyer is right after your injury. While you can handle your workers’ comp claim process alone, an experienced attorney can help you in several ways, including:
- Filing paperwork
- Ensuring you understand and meet all deadlines
- Avoiding mistakes that lead to denied claims
- Guiding you throughout the appeals process if necessary
- Helping you negotiate a favorable settlement
- Representing you in litigation if any dispute arises
What Types of Injuries Get Workers’ Comp in PA?
Workers’ compensation covers any injury or medical condition connected to your job, whether resulting from a sudden event, repetitive work or prolonged exposure. This applies to almost all on-the-clock injuries and some off-the-clock injuries when doing work-related tasks or following instructions from your employer. The most common work-related injuries leading to workers’ compensation in PA include:
- Strains and sprains (35.6%)
- Bruising and crushing injuries (21.7%)
- Lacerations, cuts and punctures (15.6%)
- Fractures (3.6%)
- Work-related illnesses (1.7%)
Work-Related Injuries by Profession
Work-related injuries can occur in any industry. Whatever your profession, if you’ve been hurt on the job, a Pennsylvania workers’ compensation attorney can help you with your claim. However, workers in some industries are more vulnerable to certain types of injury. According to the 2023 Workers’ Compensation Annual Report, the industries with the most workers’ compensation claims for injury or illness statewide were:
- Trade and transportation: 44,084 injuries and illnesses, with overexertion injuries being the most common.
- Education and health services: 42,491 injuries and illnesses, with “struck by” injuries being the most common.
- Manufacturing: 22,176 injuries and illnesses, with overexertion injuries being the most common.
- Professional and business services: 12,693 injuries and illnesses, with “struck by” injuries being the most common.
- Public administration: 11,082 injuries and illnesses, with overexertion injuries being the most common.
- Leisure and hospitality: 10,987 injuries and illnesses, with “struck by” injuries being the most common.
- Construction: 8,731 injuries and illnesses, with overexertion injuries being the most common.
Meet Frommer D’Amico’s PA Workers’ Comp Attorneys
If you’re looking for help with your workers’ compensation case in Pennsylvania, the attorneys at Frommer D’Amico are ready to fight for you. John Frommer and Joe D’Amico are certified specialists in PA workers’ comp laws and have decades of experience. When you work with Frommer D’Amico on your workers’ comp case, you get access to 24/7 personalized legal support and free case management.
Contact us for a free consultation to get help with your workers’ comp case.
