Coatesville Workers’ Compensation Lawyer

Pennsylvania’s Workers’ Compensation law offers medical and financial support for job-related injuries or illnesses. As a no-fault system, it provides medical care, wage loss compensation, and death benefits, with most employers required to carry workers’ compensation insurance.

Eligibility for Workers’ Compensation

Most employees are covered, but certain requirements must be met to qualify for benefits.

• Employment Status: You must be an employee of a company or individual that carries workers’ compensation insurance.

• Workplace Injury or Illness: Your illness or injury occurs as a direct result of your employment activities or while you were performing work-related duties.

• Timely Reporting: You must report your injury or illness to your employer within 120 days from the date of the incident or from the date you became aware of a work-related illness.

• Medical Treatment: In most workers’ compensation cases, you must seek medical treatment for your injury or illness to be eligible for medical benefits under workers’ comp.

• Coverage Under the Law: Not all employees are covered under Pennsylvania’s Workers’ Compensation Act.

Workers’ Compensation Benefits

A key part of the workers’ compensation system is medical coverage for treatment like hospital visits, surgeries, and rehab, helping injured employees recover without financial strain.

In addition to medical care, workers’ comp provides wage loss benefits for those with temporary or total disability or lasting damages. Payments are based on a percentage of average weekly wages. For severe cases, specific loss benefits may be available, such as for losing a limb or hearing.

Here is a summarization of the benefits available:

• Medical Benefits: Covering all necessary medical care related to the work injury.

• Wage Loss Compensation: Providing financial assistance when damage prevents an employee from working, either partially or totally.

• Specific Loss Benefits: Awarded for certain types of permanent work injury, such as loss of a limb or loss of vision.

• Temporary Partial Disability: Coverage for employees who can still work but at a reduced capacity due to their work-related damage.

• Permanent Disability: Benefits for employees who suffer permanent impairments affecting their ability to earn wages.

• Death Benefits: Offered to the dependents of an employee who dies as a result of a work-related injury or illness, covering burial expenses and providing financial assistance.

The workers’ compensation system helps employees recover without facing financial hardship from medical expenses or lost income. Knowing these benefits is key to getting proper support after the accident.

Common Reasons for Workers’ Comp Claim Denials

Dealing with workers’ compensation claims in Pennsylvania can be tough, especially if your claim is denied. Common reasons include missing deadlines, not enough proof that the injury is work-related, or incomplete medical records. Some denials also say the problem was there before or isn’t serious enough. Knowing these reasons can help you decide if you should fix the issue or appeal.

When to consider an appeal:

• Insufficient Evidence: If additional medical evidence or witness testimonies emerge that can substantiate the claim.

• Discrepancies in Report Timelines: If there are valid reasons for any delay in reporting the injury or illness, that can be documented and justified.

• Disagreements on the Severity of the Injury: If further medical evaluations support the severity of the injury or its direct relation to workplace activities.

• Misclassification of the Injury: If the damage was incorrectly categorized.

If your claim is denied because of fixable issues, you may be able to appeal by adding any extra necessary documentation. It’s important to talk to a lawyer who knows workers’ comp. They can help you through the appeal and make sure you get the maximum compensation allowed under Pennsylvania law.

What To Do If Your Workers’ Compensation Claim Is Denied

If your claim has been denied and you believe you are still owed damages, the initial step is to thoroughly review the denial letter to understand the reasons behind the decision. You should collect any additional evidence that may support your claim, including medical records, witness statements, or anything else that addresses the reasons for denial. At this stage, consulting with an experienced workers’ compensation attorney can be invaluable.