What Does Workers’ Compensation Cover?
Whether you’ve just been injured on the job or you’re reviewing company benefits and policies, It’s important to understand what workers’ compensation is all about. This is especially true for those doing manual labor or anything physical in nature; however, neither severity of injury nor the industry you work in will prevent you from being eligible for workers’ compensation. To better understand what’s covered, we’ve broken the topic down for you below.
What injuries are covered by workers’ compensation?
To answer that, we first need to define ‘work injury.’ For workers’ compensation claims, a work injury is “any injury, medical condition, or disease that is caused by a person’s job, according to Section 301(c)(1) of the Pennsylvania Workers’ Compensation Act, 77 P.S. §411(1).”[1] Although the Act itself does not provide a list of specific injury types, it merely stipulates that the condition must be related “to the worker’s employment” and additionally “occupational diseases and pre-existing conditions that are aggravated by an individual’s job.”[2]
You must inform your employer when you get hurt. Part of the worker’s compensation law requires employees who are injured to provide notice within 21 days of the injury, or at the latest, within 120 days of the injury, to be eligible for claims.
Another important distinction to remember: not only are injuries incurred on the job eligible for compensation, but even those that are simply aggravated by employment are covered, regardless of your prior physical condition.
What if I have sustained scarring, amputation, or loss of sight or hearing?
You may also be eligible to receive compensation benefits for specific things, including (but not limited to):
- Hearing and vision loss
- Amputations
- Face, neck, or head scarring
- Mental and physical disabilities
- Handicap vehicles, prosthetics, hearing aids, and glass as required by your injury
The above and others like them are considered “specific loss benefits.” These benefits are paid apart from your ordinary wage-loss benefits.
How will my wage loss be determined?
Wage-loss benefits are only available “if it is determined that you are totally disabled and unable to work, or partially disabled and receiving wages less than your pre-injury earnings.”[3] From there, your wage-loss benefits are calculated on your average weekly wage. This is typically two-thirds of the amount you were earning weekly, before you were injured.
Some workers may receive a fixed rate, or 90% of their previous average earnings (depending on certain factors).
If you are receiving workers’ compensation benefits, it’s imperative that you report income from any other jobs you were or are currently doing, besides the one you were injured on. This is called concurrent employment, and you may be entitled to a greater compensation rate based on that additional income. An attorney experienced in workers’ compensation laws should be consulted to ensure you’re reporting this other income correctly throughout the entire case. Being without skilled and capable counsel will put you at a severe disadvantage in a workers’ compensation case.
Who will be paying my medical bills?
Arguably, one of the biggest questions you may have after sustaining a work-related injury is how you’ll pay for any medical bills you incur. It’s important to note: injured workers are never required to pay fees or co-pays for any medical care received due to a work injury. Any hospital, doctor, or medical practitioner you visit should submit all bills to your employer’s insurance company for payment.[4]
Additional payouts
You may also be eligible to receive benefits from Social Security, unemployment, and more. Receiving these benefits will reduce those received from workers’ compensation. In either case, your attorney will be able to tell you whether you’re eligible for additional benefits such as Social Security. Other aspects of your workers’ compensation agreement/claim may be affected by these other benefits, hence the necessity of consulting with a workers’ compensation attorney.
From beginning the process to returning to work, Westmoreland Injury Attorneys are here to help you work through your workers’ compensation claim. We want you to feel confident, and to help you get the compensation you deserve. To speak to one of our skill workers’ compensation attorneys, call us today at (724)-836-4380 or contact us online
[1] http://www.dli.pa.gov/Businesses/Compensation/WC/Pages/About-Workers’-Compensation.aspx#other
[2] http://www.dli.pa.gov/Businesses/Compensation/WC/Pages/About-Workers’-Compensation.aspx#other
[3] http://www.dli.pa.gov/Businesses/Compensation/WC/Pages/About-Workers’-Compensation.aspx#other
[4] https://www.workcomppa.com/frequently-asked-questions-about-pennsylvania-workers-compensati.html
