Chester Workers’ Compensation Lawyer

Workers’ compensation is an insurance program that offers wage replacement and medical benefits to employees injured or made ill while on the job. It serves as a safety net, ensuring that injured workers get the compensation they deserve without having to navigate the intricacies of personal injury cases. However, the process can often be complicated and bureaucratic, creating a need for legal expertise.

Pennsylvania’s Workers’ Compensation System

The Pennsylvania Workers’ Compensation Act provides benefits for medical expenses and wage loss if you suffer a workplace injury. If your injury results in permanent loss or loss of use of a body part, hearing, vision, or causes serious disfigurement, you may be entitled to specific loss benefits. These are separate from wage-loss benefits for being unable to work. These benefits are available no matter who was at fault.

The process can be challenging. You must follow strict rules and deadlines to secure your benefits, and employers or insurance companies may try to deny your claim. Having a workers’ compensation lawyer like Deborah M. Truscello can help protect your rights and ensure your case is handled properly.

Eligibility for Workers’ Compensation

To be eligible for workers’ compensation in Pennsylvania, there are certain requirements that must be met:

1. Most employees are covered. Independent contractors and volunteers are generally not, though some “contractors” may qualify as employees under PA law.

2. The injury must be related to your job and occur while performing duties for your employer. This means it must have occurred while you were doing something on behalf of your employer or during your employment. If the injury happens outside the workplace but is work-related, you may still be eligible.

3. You must report your injury within 21 days to receive benefits starting from the date of injury. If you report after 21 days but within 120 days, you may still receive benefits, but only from the date you notified your employer.

These requirements underscore the importance of legal guidance to ensure all conditions are met and your rights are fully protected.

Workers’ Compensation Benefits

Pennsylvania workers’ compensation law ensures that employees receive approximately two-thirds of their average weekly wage (AWW) for temporary total disability, up to a legislated maximum amount. Benefits may continue as long as you are totally disabled. Under Pennsylvania law, insurers can request reviews, such as an Impairment Rating Evaluation, which may affect the type or duration of benefits. Employers or insurers may also seek to change, limit, or end benefits under certain circumstances, and wage-loss benefits are tax-free. These benefits cover medical bills, lost wages, and, in certain cases, specific loss or disfigurement benefits.

Total disability benefits continue as long as you are unable to return to work due to a work-related injury. Benefits may change or end in the following situations:

1. Full recovery: If you fully recover and have no medical restrictions, benefits will end.

2. Return to work: If you return to your pre-injury job at the same pay, your benefits will end.

3. Other available work at equal or higher pay: If you are medically cleared for suitable work at equal or higher wages, wage-loss benefits will end, though medical benefits may continue.

4. Other available work at lower pay: If you are medically cleared for suitable work at lower wages, benefits may shift to partial disability.

5. Impairment Rating Evaluation (IRE): If an IRE changes your status from total to partial disability, wage-loss benefits may be limited to 500 weeks, though medical benefits continue.

In the unfortunate event of a severe injury, additional benefits may be available. Pennsylvania law provides specific loss benefits for the loss or loss of use of certain body parts, vision or hearing loss, and serious facial disfigurement. Death benefits are also available for dependents in fatal cases.

Supporting Chester County Workers Injured at Work

Hurt on the job? Work injuries from construction accidents or routine job duties can lead to serious injury. Our legal team helps you pursue the workers’ compensation benefits available under PA law, including wage-loss, medical coverage, and specific loss or death benefits when applicable. Many employees risk losing benefits by missing deadlines or taking quick employer offers. Let an experienced lawyer fight for your recovery.

Under Pennsylvania law, you are entitled to medical care and lost wages if your claim is filed properly and on time. Still, even valid claims can face challenges from employers or insurers. That’s where our law firm comes in. We work with co-counsel and use strong legal resources to handle complex cases, including those involving long-term total disability, specific loss benefits, or disputes over your job duties.

If your injury results in missed work, a workers’ comp lawyer like Deborah can help you pursue total disability benefits if you meet the legal requirements showing you cannot return to your pre-injury job and your employer has not offered suitable work within your medical restrictions

Common Reasons For Workers’ Comp Claim Denials

While the workers’ compensation benefits in Pennsylvania are meant to provide much-needed financial support for injured employees, unfortunately, not all claims are approved. Some of the common reasons for claim denials include:

• Missing deadlines: You must report a work-related illness or injury within 21 days to receive benefits from the date of injury. If you wait longer than 21 days but notify your employer within 120 days, you may still receive benefits, but only from the date of notice. If you fail to report within 120 days, you are not eligible for benefits.

• Failure to seek medical attention: If an employee does not seek medical treatment for their workplace injury or illness, the insurance company may deny the claim.

• Pre-existing conditions: Insurers may say the injury is from a pre-existing condition, but if work made it worse, the claim may still be valid.

• Lack of evidence: The employee must prove the injury is work-related; without enough evidence, the claim can be denied.

What To Do If Your Workers’ Compensation Claim Is Denied

If your claim has been denied, don’t panic. The first step you should take is to contact a knowledgeable and experienced workers’ compensation attorney like Deborah M. Truscello. They will review your case and determine the best course of action for appealing the denial.

It’s also crucial to act quickly, as there are strict time limits for appealing a denied claim. If your claim has not been accepted, you must file a Claim Petition within three years of the injury date. If you were receiving benefits that have stopped, different deadlines apply for modification, reinstatement, or review petitions. If a Workers’ Compensation Judge rules against you, you have 20 days to appeal to the Workers’ Compensation Appeal Board.