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Injuries That Qualify for Workers’ Compensation

H. Rosen Law, P.C. June 15, 2023

Business woman suffering from back pain in officeIf you have been injured on the job in Pennsylvania, you may be eligible for workers’ compensation benefits. These benefits can help cover your medical expenses and lost wages while you are unable to work. But, how do you know that your injury qualifies for workers’ compensation?  

Consider speaking with our workers’ compensation attorney at H. Rosen Law, P.C. to review your specific case and determine whether your injuries qualify for workers’ compensation. We serve injured workers in Philadelphia, Pennsylvania, as well as other parts of Southeastern Pennsylvania, such as Harrisburg and Scranton.  

Brief Overview of Workers’ Compensation in Pennsylvania

In Pennsylvania, most employers are required to carry workers’ compensation insurance, which means that most employees are covered by the system. To be eligible for workers’ compensation benefits, you must have been injured while performing your job duties.  

This could include injuries that occur suddenly (e.g., falling from a height) as well as injuries that develop over time due to repetitive motions (e.g., carpal tunnel syndrome). However, not all injuries qualify for workers’ compensation benefits.  

Injuries That Qualify for Workers’ Compensation Benefits

There is a wide range of injuries that qualify for workers’ compensation benefits. In fact, any injury/illness that occurs at work and in the course of employment or is caused by work is covered by workers’ comp insurance, though there may be some notable exceptions.  

Common types of injuries suffered by workers who seek workers’ compensation benefits include but are not limited to: 

  • Back injuries 

  • Traumatic brain injuries 

  • Burns 

  • Broken bones 

  • Lacerations 

  • Cuts 

  • Soft tissue injuries 

  • Loss of limbs 

  • Strains and sprains 

  • Repetitive motion injuries 

This is a non-exhaustive list of injuries that may qualify for workers’ compensation benefits when certain requirements are met (i.e., it occurred in the course of employment or was caused by work).  

Injuries Not Covered

While workers’ compensation can be a valuable safety net for many workers, there are certain injuries that are typically excluded from coverage. These include: 

  • Injuries sustained while impaired by drugs or alcohol. If an accident occurs while an employee is impaired by a substance, it can be difficult to prove that the injury was directly caused by work-related tasks. In some cases, employers may also conduct drug and alcohol testing following an injury, and a positive test result could lead to a denial of workers’ compensation benefits. 

  • Pre-existing injuries or illnesses (unless they were worsened by the job). If you have a pre-existing injury or illness, such as a chronic back problem or diabetes, you may still be eligible for workers’ compensation benefits if that condition is worsened or aggravated by work-related duties. However, if the condition existed prior to being hired, and it is not made worse by work-related activities, you may not be eligible for benefits. 

  • Self-inflicted injuries. Workers’ compensation benefits do not typically cover self-inflicted injuries. This includes injuries that are sustained intentionally, such as cuts or burns, as well as those that occur due to reckless behavior or neglect. 

  • Injuries sustained during horseplay. If you are injured while engaging in horseplay or other non-work-related activities while on the job, you may not be eligible for workers’ compensation benefits. Horseplay is any act or conduct that is not related to your job duties and is done to deliberately annoy, harass, or interfere with your co-workers. 

  • Injuries sustained while engaging in behaviors that violate company policy. If you are injured while engaging in behaviors that violate company policy, such as fighting or stealing from the company, you may not be eligible for workers’ compensation benefits. In these cases, employers may argue that the employee was not acting within the scope of their employment when the injury occurred. 

You might want to consult with a knowledgeable attorney to determine whether your injuries qualify for workers’ compensation in Pennsylvania. Reach out to H. Rosen Law, P.C. to schedule a free case review.  

Available Benefits

If you are eligible for workers’ compensation benefits in Pennsylvania, there are several types of benefits that you may be entitled to receive:  

  • Medical expenses. Workers’ compensation pays for all medical expenses related to your work-related injury or illness, including doctor visits, hospital stays, prescription drugs, and medical equipment. 

  • Wage-loss compensation benefits. If you are unable to work due to your injury or illness, you may be entitled to wage-loss benefits. These benefits will replace a portion of your lost wages while you are out of work. 

  • Partial disability benefits. If you are able to return to work but are not able to perform the same job duties as before your injury, you may be entitled to partial disability benefits. These benefits will replace a portion of your lost wages due to a reduction in your earning capacity. 

  • Temporary total disability benefits. If your injury or illness has resulted in a total disability that is expected to be temporary, you may be entitled to temporary total disability benefits. These benefits will replace a portion of your lost wages while you are unable to work and will continue until you are able to return to work or until you reach maximum medical improvement. 

  • Specific loss benefits. If you have lost a body part, such as a finger or an arm, due to a work-related injury, you may be entitled to specific loss benefits. These benefits are designed to provide compensation for the loss of a body part and are typically paid out in a lump sum. 

  • Travel expenses. If your injury requires you to travel for medical treatment, workers’ compensation will cover your travel expenses, including mileage, lodging, and meals. 

  • Death benefits. If a work-related injury or illness has resulted in the death of an employee, their dependents may be entitled to death benefits, including compensation for funeral expenses and a portion of the deceased employee’s wages. 

If you do not understand which benefits are available in your particular case, you might want to consult with an experienced workers’ compensation attorney.  

Seek the Benefits You Deserve

If you have questions about what types of injuries may be covered under Pennsylvania workers’ compensation laws, or if you need assistance with your claim, contact H. Rosen Law, P.C. today. With the right guidance, you can receive the benefits you deserve and move forward in your recovery with confidence. Call our office to set up a free consultation with our attorney.