What Types of Injuries Are Covered Under Workers’ Compensation in PA?

Are you injured and unable to work? Did you get in a serious accident on the job that sidelined you for days, weeks or months? If you need legal help for your work-related injuries, we can help. Undoubtedly, you have many questions about what to do if you get injured at work. If you want to learn more about your legal options for work-related injuries, how much you could be eligible to receive from your employer and where you can turn for legal help, you’ve come to the right place.

For most employees injured on the job, workers’ compensation will provide wage loss benefits, cover their medical costs and sometimes offer other benefits. While many workplace injuries occur for obvious reasons — a worker slips and falls on a wet floor, a piece of equipment falls on a worker and injures their shoulder, or a truck driver making a delivery is involved in an accident, to give just a few examples — a worker can also suffer injuries that may or may not fall under the guidelines of workers’ compensation.

Often, these injuries occur outside the workplace, after hours, at a company event where attendance is voluntary, or while traveling to or from work. Yet sometimes, even injuries sustained in these situations can be eligible for workers’ compensation. Much depends on what the worker was doing when they were injured, such as if they were intoxicated or “under the influence” of drugs at the time and place the injury occurred.

You may have many questions about your workers’ compensation case and your situation. We compiled the most common questions we hear at our practice and put together the information we feel you might need.

I Got Injured at Work — What Should I Do? 

When you get injured at work, you should seek immediate medical care, especially if you’re seriously injured and may need emergency or lifesaving treatment. Don’t delay.

As soon as you can, report the injury at your place of work and follow up to ensure your workers’ compensation claim is filed correctly. Contact Frommer D’Amico, and we will manage your case at no charge. We don’t charge fees to get your late checks fixed or your injury description corrected. If your claim is denied, we can help fast, often guiding you to alternative benefits at no charge while we fight your case. You need money to pay the bills. We get it.

Many clients have already worked with us. In fact, our attorneys have secured more than $50 million in settlements for our clients.

What Qualifies as a Work-Related Injury?

Whether your injury occurred suddenly at work, such as in a slip or fall, or developed over time, such as with carpal tunnel syndrome, you need to show your injury was connected to your job if you want to collect workers’ compensation benefits. Legally, this is known as “arising out of employment and occurring during the course of employment” or AOE/COE. Essentially, you need to show your work caused a medical condition.

Any injury or illness is considered work-related if it was caused by a specific event at work, caused by repetitive work, or if exposure to any chemical or substance while at work contributed to its development.

1. On-the-Clock vs. Off-the-Clock Injuries

Any injury that occurs during the regular workday will almost certainly be eligible for workers’ compensation benefits. That holds true whether you are at your place of employment or working off-site. The only possible exceptions to this are if you’re taking your lunch break away from work or if you have asked to be excused for an hour to go to an outside appointment not connected with work and are injured while on your way to or from the appointment. There are exceptions where traveling employees are covered for injuries while traveling, even if you are eating dinner, for example.

Off-the-clock injuries may be eligible for workers’ compensation. For instance, if you have finished work for the day, are on your way to your car in the company parking lot, and slip and fall, you’re probably eligible for workers’ compensation. The moment you leave the parking lot and begin your drive home, if you’re injured in an accident, you may no longer be eligible.

The same is true if you are injured on your way to work in the morning or while going home in the evening. This isn’t considered eligible for workers’ compensation. If you’re injured while taking a business phone call on your way to or from work, however, you may qualify for workers’ compensation benefits. Also, certain traveling employees may be covered if traveling is part of your job.

Often, determining whether off-the-clock injuries are eligible for workers’ comp benefits depends on what you were doing at the time. For instance, if your official workday day doesn’t start until 9 a.m., but your boss asked you the day before to pick up donuts for an early morning meeting, and you get injured while picking up the donuts, you may be eligible for workers’ compensation. The same is true if you’re picking up your boss’s dry cleaning after work or you’re a traveling salesperson on your way to meet with a client in the morning.

If you’re injured while doing anything work-related or that your employer instructed you to do, you’re eligible for workers’ compensation.

2. On-Site Injury vs. Preexisting Condition

An on-site injury can sometimes be more than just what people traditionally think of as being on-site. Depending upon the nature of your job and where you perform your job-related duties, you don’t necessarily have to be located at your actual place of work. While almost all injuries that occur at a traditional jobsite will be covered by workers’ compensation, if you are working for the day at home because your place of employment offers that kind of flexibility or you traveled to another city for an important meeting, these can be looked at as being injured “on-site.”

Many people may believe if they have a preexisting condition and it worsens because of a job-related injury, they won’t be covered by workers’ compensation. This isn’t the case. For instance, if you had a preexisting back problem and your job required you to lift a heavy object, injuring your back again, your injury would very likely be covered by workers’ compensation. That’s because the new injury “aggravated” the preexisting condition.

The Pennsylvania Workers’ Compensation Act says an employer must provide wage loss and medical benefits to an employee who aggravates a preexisting condition. The employer must do this whether this condition is visible or known to the employee or even if the employee did not know about it.

This preexisting condition does not need to be connected to anything that may have previously happened at work. For instance, if an employee was injured in a car accident before or after taking a job and the injury sustained in the car accident is made worse as a result of work activities, the employee is eligible for workers’ compensation benefits.

3. Doing Your Job vs. Horseplay on the Job

If you are performing duties associated with your job and you are injured, you are eligible for workers’ compensation. If you’re on your jobsite and you suffer an injury while you are engaged in horseplay with, or pulling a practical joke on, your fellow employees, it’s possible you will not be eligible for workers’ comp benefits.

This is also the case for any fights in the workplace. If you and a fellow employee get into a fistfight over your favorite football teams and you are injured, you may not be eligible for workers’ compensation, even if you are on the jobsite.

Like most workers’ compensation rules, there can be exceptions to these situations. If you and your fellow employees regularly engage in horseplay and your boss ignores or tolerates it, then you may be able to argue in favor of receiving workers’ comp benefits. Also, if your fellow employees are engaged in horseplay, and you are an innocent bystander but are injured as a result of their activities, you may be eligible for workers’ compensation benefits.

As far as fighting with a co-worker is concerned, you are not covered if you fight about a football game. If the fight occurs because you have criticized a co-worker’s work habits and they hit you and injure you after you have made these comments, you also may be eligible for workers’ compensation benefits.

If you are injured on a job, regardless of the circumstances, assume you are eligible for workers’ compensation benefits. Report the injury to your boss or supervisor immediately, seek medical attention and contact a workers’ compensation lawyer as soon as possible.

What Injuries Qualify for Workers’ Compensation?

Pennsylvania workers encounter many potential hazards in the workplace, with some affecting certain industries more than others. The private transportation and warehousing sector experiences high numbers of fatal injuries, as does the private construction industry. The education and health services industry ranks high in terms of nonfatal occupational injuries and illnesses, as do the trade, transportation and utilities sectors.

Here are some of the industries with the most frequent injured workers’ compensation claims.

Trade, Transportation and Utilities

Sanitation workers experience daily hazards at their jobs. Some of their common claims include respiratory issues from exposure to toxic gases and back strain from lifting heavy garbage cans.

Delivery workers are covered for compensation under Pennsylvania law, even if they’re part-time workers. Injuries faced in this field of work have the potential to be life-altering, like motor vehicle accidents. Drivers may need to take an Independent Medical Examination (IME), which could prevent them from returning to work in serious cases. A workers’ comp attorney can help you attain financial security while you give yourself time to heal instead of returning to work prematurely.

Health Care Services

Health care workers are prone to workplace accidents. Here are a few of the workplace hazards they may experience:

• Exposure to toxins
• Lifting heavy patients off beds
• Exposure to workplace violence and physical threats from angered and unstable patients
• Repetitive strain injury from long shifts
• Injuries from handling dangerous equipment and radiation

Health care workers could qualify for compensation if they have work-related injuries that prevent them from doing their jobs. We can help them understand their rights and find the best way forward to get them benefits they may be entitled to.

Construction Work

The construction field can pose numerous hazards to workers. The Occupational Safety and Health Administration outlines the Fatal Four as the leading causes:

• Falls
• Struck-by
• Caught in/between
• Electrocutions

Even if construction injuries are nonfatal, they can still prevent workers from being able to return to their typical duties. The loss of income can have a serious toll on workers and their families. Construction workers are eligible for coverage from the first day of being hired. Some employers go to great lengths to prevent workers from receiving compensation and may even rush them back into work before they have fully recovered. Consulting a construction workers’ compensation attorney can help you learn your options and seek compensation for injuries.

What Types of Work Injuries Happen Most Often in Pennsylvania?

According to the United States Bureau of Labor Statistics, Pennsylvania’s private industry employers reported 115,200 nonfatal workplace injuries and illnesses in 2023. Consider common injuries and the industries that experience them the most:

• Sprains and strains: In Pennsylvania, the most common work-related injuries are musculoskeletal injuries — especially strains and sprains. Workers in the education and health services, trade and transportation, and manufacturing industries experience these injury types the most.
• Amputations, enucleations and loss of use: These types of work-related injuries are the least common in Pennsylvania. Manufacturing workers and trade and transportation workers experience amputations, enucleations and loss of use the most.
• Burns (heat and chemical): Under Pennsylvania’s workers’ compensation system, employees who experience burn injuries at work are eligible for compensation. These injuries are on the lower end of the workplace injury and illness spectrum. Workers in the leisure and hospitality, manufacturing, and education and health services industries encounter them more often.
• Contusions, crushing and bruising: Crushing, bruising and contusions like those experienced in conveyor belt injuries rank high among work-related injuries in Pennsylvania. The industries most affected by them are the education and health services, trade and transportation, and manufacturing industries.
• Cuts, punctures and lacerations: These types of injuries affect workers in the manufacturing, trade and transportation, and education and health services industries the most.
• Fractures: Fractures are typically caused by vehicle crashes, impacts from equipment, and slips and falls. They rank lower on Pennsylvania’s workplace injury and illness spectrum and are more common among workers in the education and health services, trade and transportation, and manufacturing industries. 
• Occupational illnesses: Occupational illnesses rank third to last on the workplace injury and illness spectrum. They most affect workers in the trade and transportation, education and health services, and public administration industries.

My Employer Claims My Injury Is Not Covered Under Workers’ Comp

Most workers in Pennsylvania are covered, including part-time and full-time workers. Sometimes, employers misclassify workers as contractors or self-employed workers to avoid paying premiums. If you think this has happened to you or if your employer is trying to claim you weren’t injured at work, help is available. Contact Frommer D’Amico in Harrisburg, PA  for an in-depth analysis of your situation if you are unsure of what to do if you got injured at work and your employer is making these claims. We will look over all the documentation and contracts to ensure you are not losing out on money that should be coming to you.

PA Workers’ Compensation Exemptions

In Pennsylvania, any business that employs at least one person is required to provide workers’ compensation. Employees are eligible for workers’ compensation from the first day they begin a job. This is true whether they are working part-time or full-time.

There are some exceptions under Pennsylvania law. Employees in these fields cannot apply for workers’ compensation:

• Federal and military workers covered by federal legislation for workplace injuries
• Railroad workers covered under a separate act
• Dockworkers and harbor workers have their own system of workers’ compensation
• Independent contractors or casual workers whose work is casual in nature and not related to the regular business activities of the person who employs them
• The spouses and children (under 18) of farmers who perform agricultural labor
• Domestic workers who decided not to be covered by the Workers’ Compensation Act
• The sole proprietor of a business or a general partner
• People who have been granted exceptions by the Department of Labor and industry because of their religious beliefs
• Executive officers granted an exclusion by the department
• Licensed real estate salespeople or real estate brokers paid on a commission-only basis, thus qualifying as independent contractors for tax purposes

Where Can I Turn for Legal Help for Work-Related Injuries?

It’s easy to see why making a workers’ compensation claim can be challenging. That’s not considering what happens if your original claim is denied and you need to make an appeal.

The attorneys at Frommer D’Amico are certified workers’ compensation experts in Pennsylvania. Our goal is to make sure you get all the benefits you are eligible to receive and save you money at the same time. We can help you with all aspects of the workers’ comp process, from understanding what is considered a workers’ compensation injury to filing your claim and dealing with late checks or delays.

We work with clients with all types of injuries, from repetitive strain and stress to equipment or machine failure injuries and more. We offer a free initial consultation and free case management for our clients.

A serious injury can be devastating and can affect your ability to work. Contact us today for a free consultation if you would like to know more or if you need help because your workers’ compensation benefits have been denied or delayed. We have secured more than $50 million in settlements on behalf of clients and serve clients across Pennsylvania. If you have been injured and have questions, contact John Frommer or Joe D’Amico right away at 717-400-1405 or 717-573-0057 for after-hours calls.