Tips and Strategies for a Successful Workers’ Comp Case
Getting injured is the last thing you expect when you go to work in the morning. And yet, day in and day out, workers suffer on-the-job injuries and illnesses that leave them injured, sick, and unable to perform their job and care for their families.
If you’ve suffered a work-related injury, illness, or condition in Delaware County, workers’ compensation benefits can help you pay your medical bills and living expenses while you’re unable to work. But getting the benefits you need is not automatic. Furthermore, your claim may be denied by your employer or their insurance company if filed improperly. At Saffren & Weinberg, our team of Delaware County workers comp attorneys can help.
What Does Delaware County Workers Compensation Cover?
Workers’ compensation is a type of no-fault insurance required by most employers in Pennsylvania. It provides essential benefits to workers who have been injured or suffered an illness or condition on the job. Workers’ comp provides several important types of benefits for injured workers.
- Wage-loss benefits pay two-thirds of the average weekly pay of the disabled individual, depending on the status of their benefits.
- Medical care benefits pay your medical bills and other medical service costs that have been rendered by an approved doctor or other healthcare provider.
- Specific loss benefits pay additional benefits if you have suffered the loss of a body part, sight, hearing, or permanent disfigurement of your head, face, or neck.
- Death benefits pay family members of the injured party if the injury or illness results in a fatality.
In Pennsylvania, you may be able to collect workers’ compensation for
- An injury that was caused by a specific on-the-job incident
- Any repetitive activity required by your job that has resulted in an injury or condition
- Any pre-existing condition that was aggravated by your work requirements. The pre-existing condition does not have to be work-related.
- A disease designated an occupational disease or other disease that meets specific criteria.
In order to receive workers’ compensation benefits, a claim must be filed and specific rules must be followed. Mistakes in filing the claim may cause the insurance company or your employer to deny benefits.
Report Your Injury
Reporting your injury immediately to your employer is the first step in a successful workers’ compensation claim. Workers’ compensation insurance companies often deny a claim for an injury that is not reported immediately.
In Pennsylvania, you have 21 days to report a work-related injury or illness to your employer to ensure that you get benefits as quickly as possible. Report your injury, even if you aren’t sure you will be missing work because of it. Inform your employer in writing, and keep a copy for your records. Do not rely on your doctor to do this for you. After 120 days, you may lose your right to workers’ compensation benefits entirely.
Get Medical Treatment
Get immediate medical treatment. The longer you wait to get treatment, the more it will be assumed that your injury or illness is not that serious.
Make sure that you inform your doctor that this is a work-related injury. And while your doctor can provide treatment for your injury to initiate your claim and receive benefits, be aware that you may be required to see another healthcare provider who has been approved by your employer within 90 days of the incident.
Make Sure You Report Exactly How You Were Hurt
Workers’ compensation puts a great deal of weight on the information in the initial report of your incident.
You will want your report and your medical records to be very clear about how the incident happened and the cause of your injuries. Clearly explain this to all medical providers and your employer, and be consistent so there is no room for misinterpretation. It can also help if you have a witness to the event.
Be Careful Dealing With the Insurance Company
Insurance companies prefer to avoid paying benefits and will often look for possible ways to deny a claim.
Although they will need access to your medical records, you should only provide them with limited access to the records and bills as they apply to your specific claim. Giving them authorization for more than that opens the possibility that they might look for other ways to deny you. Also, do not give the insurance company any tape-recorded information without first getting legal advice. Unfortunately, when it comes to paying claims, insurance companies are not looking out for your interests.
Do Not Miss Appointments With Your Delaware County Workers Comp Doctor
Remember, your workers’ compensation doctor has been approved by your employer and insurance company for a reason. If you miss appointments with them, it’s not just an inconvenience. If you chronically miss important appointments, it will be reported back to the very parties who control whether you get benefits.
Workers’ Comp Appeal in Delaware County
An employer or insurance company can deny a workers’ compensation application for various reasons. While this can be frustrating, if your application for workers’ comp has been denied, you can file a petition appealing the decision.
During an appeal, a judge with the Workers’ Compensation Appeal Board will review your evidence and records, the evidence for the denial, and approve or deny your appeal based on that evidence. If the appeal is denied, you may still have other options. You may take the appeal to the Pennsylvania Commonwealth Court and, if necessary, to the Pennsylvania Supreme Court.
Getting Experienced Legal Assistance
The appeals process for a denied workers’ compensation claim can be complex. Your employer and insurance company will be represented by their own attorneys. Your best chance of winning a claim, whether at the initial application phase or through appeal, is with the help of your own legal counsel. You may even be entitled to a third-party lawsuit independent of your workers’ compensation claim.
At Saffren & Weinberg, our experienced Delaware County workers comp attorneys are dedicated to getting you the benefits you are entitled to after a workplace injury or illness. If you’ve suffered a job-related illness or accident, we can help. Call us at (215) 576-0100 or contact us online to schedule a free consultation.
Disclosure:
This website is designed to provide only general information. The information presented on this website is not formal legal advice. You should not rely on any general information from any source for making legal decisions. Each legal matter is unique and requires specific attention from a qualified and experienced attorney. Unless a representation agreement has been signed with Saffren & Weinberg, we are not your legal representatives.