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  • Workers’ Compensation Application Process

    workers compensation application processIf you have been injured at work, you have the right to receive Workers’ Compensation benefits. Workers’ Compensation aims to assist workers who have been injured or have fallen ill on the job with medical bills and income replacement.

    In Pennsylvania and most other states, all but a few employers must carry Workers’ Compensation insurance. They typically purchase it through an insurance company, but some companies self-fund the benefits. Any employee hurt on the job is eligible to receive benefits, no matter who is at fault for the accident. 

    Understanding how the application process works can save a lot of stress and worry. A Philadelphia Workers’ Compensation lawyer can help with your application or any other issues related to your injury claim.

    Seek Medical Attention

    Seeking medical care for an injury or illness is your priority. After you have received immediate medical care, document the following:

    • Dates of doctor visits
    • Medical providers’ names.
    • Diagnosis, prognosis, and recommended therapies supported by official documents.
    • Receipts for medical bills, including prescriptions, surgeries, hospital stays, medical equipment, and anything else related to your work injury.
    • Videos and photos that document your condition can be helpful.

    Note that within 90 days of reporting your illness, your employer may require you to see a doctor from their approved list. An injured worker has to treat with a company-approved doctor for 90 days from the first visit only if the employer has created a list of at least six designated health care providers.

    In addition, be sure to seek medical care after an injury or work-related illness, even if you do not think it is serious. Some injuries take some time to appear. You will want to be under medical supervision and get a professional diagnosis. Medical records are an essential part of the Workers’ Compensation decision process. 

    Report the Injury to Your Employer

    Let your employer know of the injury as soon as possible. Be sure to get a copy of the official accident report. Report the incident to your employer within 120 days to maintain your right to seek benefits. 

    You might not realize that you have a work-related injury or illness for weeks or even months. As soon as your doctor diagnoses you, the time limit begins.

    File a Claim

    Your employer must submit a First Report of Injury to the Pennsylvania Department of Labor and Industry, which will generally trigger the claim process. If your employer denies your claim or fails to act, there is a strict deadline of three years from the date of injury to file a claim petition, or you will lose your rights to benefits.

    Complete the Required Forms

    After your employer files the First Report of Injury form, they or their insurer will submit additional forms to the Pennsylvania Workers’ Compensation Bureau. You should be aware of the forms submitted and may be asked to sign some of them. Request a copy of each of them. 

    Follow the Doctor’s Orders

    Your goal is to get well as soon as possible. You must follow every order from your medical provider: therapies, prescriptions, follow-up visits, imaging and other tests, and limitations. 

    If you are not actively trying to get well, there could be issues with your eligibility to receive Workers’ Compensation benefits. 

    Wait for the Approval or Denial

    The insurance company has 21 days from when they receive your claim form to approve or deny your Workers’ Compensation benefits. While the insurance company has 21 days to affirm or deny your claim, it can issue a Notice of Temporary Compensation for 90 days. This gives them 90 days to further investigate your claim. It may deny your claim at that point.

    A denial can happen for any number of reasons:

    • Injury not reported on time.
    • Claim not filed quickly.
    • No incident report.
    • Injury not that severe.
    • Impaired on the job.
    • Illegal activity.
    • Injury unrelated to work.
    • Pre-existing condition.
    • Did not see a doctor.
    • Not an employee.
    • Missing or incorrect information.
    • Suspected fraud.
    Galfand Berger Icon You have options if an employer or insurer denies your Workers’ Compensation benefits claim.

    Can I Be Fired for Filing a Workers’ Compensation Claim?

    It is illegal for any employer in Pennsylvania to fire an employee because they have filed a Workers’ Compensation claim. You can lose your job for other reasons, such as downsizing planned before your injury. If you lose your job, you will continue to receive Workers’ Compensation wage loss benefits and medical coverage.

    If you return to work and notice that you are being treated negatively, you may be experiencing retaliatory behavior for your Workers’ Compensation claim. These adverse employment actions are illegal. Adverse actions can include:

    • Being denied promotions.
    • Demotions.
    • Transferred to another position.
    • No raises.
    • Negative performance reviews.

    Consult a Lawyer Workers Compensation Application Process

    A lawyer in your area can be a valuable resource if your claim has been denied. They know the tactics employers and insurers use to deny workers their rightful benefits. They can defend against these tactics to help you get the compensation to which you are entitled. 

    If your illness or injury claim is valid, do not accept a denial. Find a lawyer immediately to help you with your claim. Unfortunately, the insurer does not have your best interests at heart. 

    If your claim has been approved, consult with your employer about when to expect payments, how long they will last, the impact on your vacation or sick days, your responsibilities, and other related issues. 

    Philadelphia Workers’ Compensation Lawyers at Galfand Berger LLP Can Help You if You Are Not Receiving Your Entitled Benefits

    If you have been injured at work, one of our seasoned Philadelphia Workers’ Compensation lawyers at Galfand Berger LLP can assist. Our dedicated legal team will protect your rights and ensure that you receive the assistance you deserve for your injuries. Call us at 800-222-USWA (8792) or contact us online to schedule a free consultation. From our offices in Philadelphia, Bethlehem, Lancaster, and Reading, Pennsylvania, we help clients throughout Pennsylvania and New Jersey, including Allentown and Harrisburg.