Starting a Workers' Compensation Claim in Pennsylvania

Posted almost 3 years ago. Applies to Pennsylvania, 2 helpful votes

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Pennsylvania worker's compensation attorneys are not surprised that oftentimes neither employers nor employees have a good idea of what to do when an injury on the job occurs. This guide discusses some of the basics.

1

Employee Responsibilities

For employees ("claimants" in workers' comp parlance), it is vitally important to report injuries as soon as they occur. This serves many practical purposes. First, a claimant will not be entitled to any workers' compensation benefits before she gives notice of the injury. Second, it makes simple common sense that an employee who notifies her supervisor right away is more likely to be believed than one who waits a few days. Third, the act of putting the employer on notice of the injury triggers certain duties on the part of the employer; in other words, after appropriate notice, the employer's clock is running to respond. The claimant must give notice to a supervisor, not just to a co-worker. The notice cannot be simply that the worker suffered an injury, but must be to the effect that the worker was injured in the course of employment. In all cases, claimants should attempt to give notice within 21 days of their injuries.

2

Employer Responsibilities - Posting Requirements

Employers who are not self-insured are required to post, in a prominent and easily accessible place, at their primary place of business and at their sites of employment, their acceptance of Article III of the Pennsylvania Workers' Compensation Act, including a statement showing the name of the insurance company carrying compensation insurance and the expiration date of the current policy. Employers are also required to post Bureau Form LIBC-500, "Remember: It is important to tell your employer about your injury," to inform employees of the name, address and phone number of their workers' compensation insurance company, their third-party administrator or their internal workers' compensation contact person.

3

Employer Responsibilities - Filing and Reporting Requirements

Employers are required to immediately report all employee injuries to their insurer. Employers are also required to file with the Bureau a report of injury within 48 hours after every injury resulting in death, and after seven days but within ten days after the date of injury for all other injuries which result in disability lasting more than a day, shift or turn of work. Within 21 days from the date the employee provides notification of an injury, the employer or its insurance carrier must either accept liability for the injury and issue a Notice of Compensation Payable or a Notice of Temporary Compensation Payable, or must issue a Notice of Workers' Compensation Denial explaining why the claim was denied. If the claim is accepted, the employer and its insurance carrier must also correctly calculate the employee's pre-injury average weekly wage and resulting compensation rate, so that the employee can be paid the correct amount of compensation benefits benefits under the Act.

4

If a Claim is Denied

If a claim is denied, the employee has three years from the date of injury to file a Claim Petition. However, claimants are well-advised to file their petition earlier to give themselves the best chance of being successful in their litigation. Workers' compensation litigation is an administrative proceeding before a workers' compensation judge, and in a claim petition proceeding the burden is on the claimant to prove that he was an employee who was injured in the course and scope of his employment, and that his injury has caused him to require medical treatment or to suffer a loss of earning capacity. For employees, it is often wise to consult with an experienced Pennsylvania workers' compensation attorney even if a claim is being paid, to be sure that the employee is receiving every benefit to which he or she is entitled. If a claimant thinks he is entitled to benefits but is not receiving them, he is well-advised to consult with a workers' comp lawyer.

Additional Resources

A good, handy reference for employers and employees can be found at the website for the Pennsylvania Department of Labor and Industry (http://www.dli.state.pa.us/portal/server.pt/community/l_i_home). For the brave souls interested in studying the actual language of the regulations, they can be found at 34 Pa.Code Chapter 121 et seq. (http://www.pacode.com/secure/data/034/chapter121/chap121toc.html).

More detailed information on starting a PA Workers' Comp Claim

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