Workers’ Compensation Attorney in Philadelphia, Pennsylvania
With almost 2 decades of experience serving clients in Philadelphia and across Southeastern Pennsylvania, our team is proud to specialize in workers' compensation law. Howie Rosen is a certified specialist in the practice of workers’ compensation law by the Pennsylvania Bar Association’s Section on Workers’ Compensation Law, as authorized by the Pennsylvania Supreme Court. We have spent years pursuing workers' compensation claims for people in Bucks, Chester, Lancaster, Delaware, Montgomery, and Berks County — and we will passionately fight for the compensation you need.
Who is Entitled to Workers' Compensation Benefits?
Workers’ compensation benefits are available to all employees injured during the course and scope of their employment. Such employees are entitled to full medical treatment, and if the injuries cause an employee to lose wages, then their employer is responsible to pay wage loss benefits. If an employee suffers hearing loss, loss of vision, an amputation, a loss of use of a body part, or a scar on the head, face, or neck at work, workers’ compensation benefits are available.
Overview of Pennsylvania Workers’ Compensation Laws
Workers’ compensation is a no-fault system by which employees who are injured on the job can receive not only ongoing medical attention but payments for any wages lost, but only up to established limits and guidelines. Since it is a no-fault system, neither employer nor employee can be held liable, and neither can generally be sued.
Some exceptions exist when the injuries are self-inflicted or result from horseplay or intoxication while on the job. Though employers cannot be sued, third parties can. For instance, if a piece of machinery an employee is operating malfunctions and causes the injury, the manufacturer, sometimes even the supplier, can sometimes be sued.
The Pennsylvania Workers’ Compensation Act does not list specific types of injuries, only that the injury must be caused by the employee’s job. A work injury also encompasses occupational diseases – such as may be caused by chemicals at work, for instance, pre-existing conditions that may be aggravated by one’s occupation. Thus, even latex allergies, strains and sprains, and hepatitis may be covered.
Filing a Claim
Workers’ compensation in Pennsylvania is often provided by an insurance company contracted by your employer, or in some cases, it may be self-insured by the employer. If an employer does not carry workers’ compensation, they can be held liable for fines and penalties; in addition, Pennsylvania also maintains an Uninsured Employer Guaranty Fund for workers who are injured at places of work without workers’ compensation coverage.
The statute of limitations for filing a claim in Pennsylvania is three years, but the law also requires that you seek medical treatment within 90 days of your injury or illness and that you notify your employer within 120 days.
However, it is obviously in your best interest to report your injury or illness immediately, even if you think the injury is minor and might go away on its own. Workers’ compensation insurance or employer self-insurance will cover your examinations and any further treatment needed.
The law also allows the employer to post a list of at least six approved medical providers, one of whom you must use to seek evaluation and treatment. Your employer cannot specify which one and the list must be widely promulgated. If your employer does not post a list, you are free to choose your provider.
There are different levels of benefits available under workers’ compensation. As soon as you report your injury or illness, your employer is required to provide you with a written notice of your rights and responsibilities under Section 306(f.1)(1)(i) of the Pennsylvania statutes.
You are entitled to receive free of charge “reasonable” surgical and medical services. In addition, medicine, supplies, hospital treatment and services, orthopedic appliances, and prostheses are covered for as long as you need them.
Even if the provider charges the employer or insurance company more than their fee schedule allows, you as the recipient of the services cannot be charged the difference.
Specific loss awards cover you if you lose the permanent use of a body part such as a finger, hand, foot, or leg, lose sight or hearing, or suffer permanent disfigurement to your head, face, or neck. If your injury results in death, your survivors will be entitled to benefits.
You may also be eligible for vocational rehabilitation and partial disability benefits if you return to work in a lower-paying position as a result of your injury.
If you have to miss days at work due to your illness or injury, you will be compensated for wages lost.
The formula used is two-thirds of your normal weekly rate, with a cap. Thus, high-income employees may be compensated at less than two-thirds. However, if you have more than one job, your income from the other job may be factored in to raise your compensation, though the cap still exists.
Appealing a Decision
Insurance companies are for-profit entities, and you can be sure they will examine your claim from every angle they can find to either reduce your benefits or deny your coverage altogether. Even if you are already receiving benefits, the insurer may decide to lower what you receive or cease paying benefits altogether.
One of the methods insurance companies and employers use to lower or terminate benefits is through an independent medical examination (IME). Generally, if they ask you to undergo an IME – which is conducted by a physical or medical group of their choosing – you must agree, but check with your attorney. You may be able to avoid an IME under specific circumstances.
If you are denied, suspended, terminated, or have your benefits reduced, you can appeal the decision to the Workers’ Compensation Bureau, which will assign a judge to hear your appeal. If the judge denies your appeal, you have 20 days to file for a review of the judge’s decision by the Workers’ Compensation Appeal Board.
Needless to say, any appeal you undertake should be done in connection with an experienced workers’ compensation attorney, who will help you prepare the documentation and testimony necessary to fight for your rights.
Workers’ Compensation Attorney Serving Philadelphia, Pennsylvania
If you have been injured or fallen ill at work in Philadelphia, Pennsylvania, or anywhere throughout Southeastern Pennsylvania, contact us immediately at H. Rosen Law, P.C. When filing a claim, you can be sure that the insurance provider, or your self-insured employer, is going to employ the advice and counsel of attorneys to limit their liability as much as possible. Don't plan to go it alone against an array of legal and medical specialists whose sole job is to limit or even deny your benefits. Let us help you from the beginning. We can help you assemble the best medical and other evidence available to help you navigate the workers’ compensation system and gain the just benefits you deserve.