How to File for Workers’ Compensation in PA

If you’ve recently been injured on the job, you probably have a lot of questions. And your main concern is likely how to file a claim so you can receive benefits. As we’ve talked about often here on the blog, Pennsylvania’s Workers’ Compensation Act assures that nearly all workers are covered. Even if your employer does not have workers’ compensation (WC) insurance, you may still qualify for benefits when you’ve been hurt at work.

So, what are the steps involved in filing a WC claim? They’re really not very complicated, but we realize that if you’ve never had a work injury before, you probably don’t know what to do first. Plus, there are several things to remember about deadlines and receiving care, too. Read on for more.

Step 1: Inform your employer about your injury

Whether your injury is new or related to a pre-existing medical condition, you are responsible for speaking up and letting your employer know that you’re hurt or ill. A wide range of injuries from concussions to knee and back problems qualify for workers’ compensation, so don’t keep your pain to yourself out of fear that it is mild or too embarrassing to explain. WC exists to ensure that you can pay medical bills and get through periods of time when you may be unable to work. You owe it to yourself – and your employer – to be upfront about injuries and illness.

It is important to realize that there is a time limit on informing your employer: 120 days from when you were first injured or became ill. That may sound like a long time, but it’s really not. Of course, letting your employer know you’re hurt or sick as soon as possible is ideal, especially if you’re already receiving medical care.

Step 2: Get medical attention

If you were rushed to the hospital in an ambulance, it’s possible this step will actually occur first, and that’s fine. Getting care for your injury should be your top priority. More commonly, though, your injury or illness will allow you a little time to seek medical attention, but it’s important not to wait too long to see a doctor.

Know that your employer may require you to be examined by a doctor who’s been pre-approved by their WC insurance company within the first 90 days following your notification that you’re hurt. You may always seek a second opinion from your preferred physician, as well, if you are concerned about the quality of the medical professionals your employer directs you to.

When you visit the doctor, remember to mention that you’re seeking care for a job-related injury so that it can be documented. Medical records play a crucial role in the WC claims process, and having complete documentation will help you if there’s a problem with your claim that requires legal intervention.

Step 3: File your claim

In Pennsylvania, your employer is responsible for submitting a First Report of Injury with the Department of Labor & Industry’s Bureau of Workers’ Compensation to begin the claims process. At that point, they will also provide you with forms to fill out and/or sign for their WC insurance company and the state Bureau. These forms can be confusing and need to be completed accurately, or you could experience problems with your claim. Help is available right here in the Greensburg, PA area if you are unsure how to complete this paperwork.

When your employer files your information with the Bureau of Workers’ Compensation, they and/or their WC insurance company will decide whether they are accepting or denying the claim. Your employer’s insurer has 21 days from the time the claims process begins to make their decision. If your claim is accepted, you will usually begin receiving benefits quickly. However, if your claim is denied, you will receive a Notice of Workers’ Compensation Denial.

While receiving this notice is a setback, it is important to remember that you have the right to contest the denial, and you absolutely should. A denial on your initial claim is certainly not the end of the road, and even though you may feel frustrated and discouraged, it’s important to remember that you have options.

Step 4: Protect Your Rights

The procedure for contesting a denied claim is clearly outlined on the denial notice. Make sure to follow the instructions carefully and file your petition within three years of the date of your injury. This is also an excellent time to consult an experienced workers’ compensation attorney for guidance and advice, as you will have an opportunity to testify before a workers’ compensation judge. An initial call for case evaluation is often free of charge.

Even if your claim has been accepted and you begin to receive benefits, know that you still may need to fight to protect your rights at some point during the process. Your benefits may change or be stopped as time goes on even if you are not fully healed. This may be based on a decision from your employer or their WC insurer, or you may decide to go back to work, but still qualify for some benefits. No matter your situation, you certainly do not want to leave benefits on the table that you deserve.

The best way to protect your rights throughout the complicated and emotionally draining workers’ compensation process is to consult an experienced attorney to help you navigate all the potential pitfalls. Here in Greensburg, PA, Westmoreland Injury Lawyers are ready to fight for your rights and ensure that you have a strong helping hand through this difficult time. Contact us today to review your case for free.