When a worker is hospitalized in connection with an injury sustained on the job, they are unable to work. Other injuries may be less serious but still hinder the ability of a worker to complete his or her duties.
Financial relief is available under both scenarios. Worker’s Compensation benefits provide a portion of lost pay and reimbursement of medical bills, regardless of the severity of an injury, as long as an employee is unable to work. Filing a claim is the first – and most important – step in the process.
The act of filing a Workers’ Compensation claim is where most injured workers will go wrong, however. A claim for Worker’s Compensation benefits must be strong from the start. A skilled Philadelphia Workers’ Compensation lawyer can assist injured employees as they compile the documentation needed to prove that they are indeed entitled to an award of benefits under Pennsylvania Workers’ Compensation Law.
Importance of Filing a Timely Claim
Immediately upon sustaining an injury, an employee must make their supervisors aware of what has happened. The longer an employee waits to report their injury, the lesser amount of benefits they will be eligible to receive. Employees who provide notice of an injury within 21 days can seek benefits from the date of their injury; those who wait longer than 21 days can only receive benefits from the date notification was given. Moreover, in most cases, an employee who waits longer than 120 days to provide notification of an injury forfeits any right to Workers’ Compensation benefits.
Once notification has been given, an employee will be notified whether their claim will be approved or denied. Occasionally, an employer provides a Notice of Temporary Compensation Payable (NTCP), whereby benefits are paid but an employer admits no liability in connection with an injury. Regardless of whether a claim has been approved, denied, or results in issuance of an NTCP, an employee can expect a decision within three weeks.
Denials Are Common; Simple Process to Appeal
A denial is disheartening, but must be challenged. Fortunately, under Pennsylvania’s Workers’ Compensation Law, there are mechanisms in place to protect the rights of those who have been unfairly denied Workers’ Compensation benefits. Injured employees have three years to file a petition with the Bureau of Workers’ Compensation. If a Workers’ Compensation judge upholds the denial, the case can be argued again before the Workers’ Compensation Appeals Board. An adverse ruling by the Appeals Board can, in turn, be appealed to the Commonwealth Court.
According to Philadelphia Workers’ Compensation lawyers, there are certain steps that can be taken during the initial notification of an injury that can bolster a claim. If any coworkers witnessed the workplace accident which led to injury, an employee should obtain from them a detailed written account. Additionally, an employer and their insurer will request all medical documentation of the injuries allegedly sustained. Employees who diligently compile such information – including records of follow-up visits, lab work, and imaging studies ordered and completed – are better positioned to establish the existence of an injury which makes continued work impossible.
ABOUT THE AUTHOR: Jeffrey Gross
As a partner with Philadelphia, Pennsylvania, firm Batt & Gross, Jeffrey S. Gross has represented injured workers in the Philadelphia area since 1991. He focuses exclusively on Workers’ Compensation litigation, including subrogation matters, full and partial disability claims, lump sum settlements, occupational diseases and workplace fatalities, and he has a long record of success aggressively pursuing the best interests of his clients.
Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.
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