FAQ: Worker's Compensation

Q: What is workers' compensation?

A: Workers’ compensation is a law that requires payment for wages and medical expenses when a worker has been injured on the job.

Q: How much will I be paid for my lost wages?

A: Under Pennsylvania law, a person who cannot work because of a work injury is entitled to at least 66 2/3% of his average weekly wage, up to the statewide maximum payment. For 2005, the maximum weekly payment is $716.00. This figure is adjusted each year, according to average earnings throughout Pennsylvania.

Q: Will my weekly payments be adjusted for inflation?

A: No. Your payments are based on your wages at the time of your injury.

Q. Will I be able to keep my health insurance?

A: Workers' compensation only pays a percentage of your wages, and it pays for medical expenses related to the work injury; it does not pay for fringe benefits such as insurance. You may have to make your own health insurance payments if you are unable to work due to a work injury

Q: How do I choose a doctor if I am injured at work?

A: If your employer has established a panel of at least 6 medical providers, and has provided that list to you when you started working and as soon as is practically possible after your work injury, you must treat with one of those providers for the first 90 days after your injury. You can go to your own doctor if you want to, but workers’ compensation will not pay for that treatment for the first 90 days. Your health insurance will probably not pay for it either. After the 90 day period has ended, you can choose any doctor. If your employer has not established a panel of medical providers, you may treat with a doctor of your choice. Also, if the insurance company has denied your claim, you can choose your own doctor.

Q. My employer doesn’t have a panel of 6 doctors, but they told me to go to “their doctor” after I was injured. Do I have to treat with that doctor?

A: No. Your employer cannot force you to go to a doctor that they choose for your treatment.

Q: I was hurt at work, but my claim has been denied. What should I do?

A: In Pennsylvania, all litigation concerning workers’ compensation claims is handled through an administrative law system run by the Bureau of Workers’ Compensation, a department of the Pennsylvania Department of Labor and Industry. Workers’ Compensation judges hold hearings concerning all contested matters, which include claims by employees for wage and medical benefits, and employer petitions to terminate or modify benefits.

Q: Do I need a lawyer for a workers' compensation claim?

A: If you are receiving benefits, and there are no contested issues with the employer/insurance company, probably not. However, if any petitions are filed to change or stop your benefits, or if you are having a dispute about your benefits, you should consult with a lawyer. Workers’ compensation is a complex area of law, and you should be represented by an attorney if there is any legal dispute about your right to receive wage or medical benefits. You should always get legal advice if you have any questions about your rights, and never settle a claim without legal advice.

Q: I'm on workers' compensation, and the insurance company wants me to be examined by a doctor that they have chosen. Do I have to go?

A: The insurance company has a right to have you examined periodically by a doctor of their choice. This is often called an "independent medical examination". If you get a notice to see a doctor, we suggest that you get legal advice.

Q: Can the insurance company make me go back to work at another job?

A: One of the biggest areas of litigation in workers' compensation involves attempts to establish an "earning capacity", or an attempt to place injured workers in light duty jobs. We strongly urge you to call us if you get any notice about being interviewed by a vocational rehabilitation service, if you are asked to apply for another job, or if you are asked to return to work at a light-duty or modified job with your employer. Any misstep can affect your rights.

Q: How are cases settled?

A: Sometimes, a case can be settled for a lump sum of money in a procedure known as a “compromise and release”, which can end the obligation for payment of wage payments and/or medical benefits. Settlements depend upon many factors, and you should never settle a workers’ compensation claim without legal advice.

Q: I was hurt at work and it was my employer's fault. Can I sue my employer?

A: No. With very rare exceptions, if an employer has workers’ compensation insurance, an employee may not sue his or her employer, or a co-worker, for injuries, but can recover workers’ compensation benefits.

Q: What are the fees for a workers' compensation case?

A: Usually, our fees are based upon a percentage of benefits. We try to recover all costs, and in some cases can also collect our legal fees from the employer or its insurer, instead of from you. All fees are discussed at the time that you hire our firm, and are always confirmed in writing with you.