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Do I Have A Personal Injury Case in Pennsylvania?

If you suffered an injury in Pennsylvania due to someone else’s negligence, you may have a personal injury case. The answer to this question matters. A valid personal injury claim can help you recover compensation for medical expenses, lost wages, and emotional distress. However, not every injury claim qualifies under Pennsylvania injury law.

What Qualifies As A Personal Injury Case?

To have a valid personal injury case in PA, you must show that someone else’s negligence caused your injuries. This means showing:

Duty of Care

The responsible party had a legal obligation to act in a reasonably safe manner.

Breach of Duty

The party failed to meet this obligation, acting carelessly or recklessly.

Causation

Their breach of duty directly caused your injuries.

Damages

You suffered financial losses, including medical expenses, lost wages, or emotional distress.

If you can establish these elements, you likely have a personal injury claim under personal injury laws in Pennsylvania.

Common Personal Injury Cases

Car Accidents

In terms of car accidents, Pennsylvania follows a choice no-fault system. This means your own Personal Injury Protection (PIP) insurance covers initial medical expenses. However, with severe injuries, you may file a lawsuit against the at-fault driver for additional damages.

Slip and Fall Accidents

Property owners must keep their premises safe. A property owner may bear liability if you slip and fall because of a hazardous condition.

Workplace Injuries

Workers’ compensation insurance covers most workplace injuries. However, you may have a personal injury case if a third party’s negligence contributed to your injury.

Medical Malpractice

Doctors, hospitals, and healthcare providers must meet a professional duty of care. If they fail to do so, resulting in injury or worsened health, you may have a medical malpractice claim.

Defective Products & Products Liability Cases

Manufacturers must ensure the safety of their products. If a dangerous product caused your injury, you may have a products liability claim. Common claims involve design defects, manufacturing defects, or failure to warn consumers about risks.

Dog Bites

In PA, dog owners bear responsibility if their pet bites or injures someone. Especially, in cases where the dog has a history of aggression.

Golden Labrador Retriever sitting outdoors on a cloudy day, looking directly at the camera.
Even the friendliest dogs can bite—understanding your legal rights after a dog attack is critical.

How Do I Prove Negligence?

Medical Records

Documentation of injuries, treatment plans, and medical expenses.

Police or Incident Reports

Official reports detailing the accident.

Photos and Videos

Images of the accident scene, injuries, or hazardous conditions.

Eyewitness Statements

Testimonies from people who saw what happened.

Expert Testimony

Professionals who can verify your injuries or explain how negligence occurred.

How Much Time Do I Have To File A Personal Injury Lawsuit?

Pennsylvania law imposes a two-year statute of limitations on most personal injury cases. You must file a lawsuit within two years from the date of your injury.

However, exceptions may apply:

Medical Malpractice

If you discover an injury later (e.g., a surgical error), you may have more time.

Minors

If a child is injured, the two-year deadline starts when they turn 18.

Government Claims

If your injury involves a government entity, you must file a notice of intent within six months.

Waiting too long may prevent you from filing a personal injury claim.

What Damages Can I Recover?

If you have a valid personal injury claim, you may recover economic and non-economic damages, including:

Economic Damages (Financial Losses)

  • Medical expenses lost wages, and rehabilitation costs
  • Property damage (e.g., vehicle repairs after car accidents)

Non-Economic Damages (Pain and Suffering)

  • Physical pain and emotional distress
  • Loss of enjoyment of life
  • Scarring or disfigurement

In rare cases, Pennsylvania courts may award punitive damages to punish extreme negligence. For example, drunk driving accidents or reckless medical malpractice.

What If I Share Some Fault For My Injury?

Pennsylvania follows a modified comparative negligence rule. You can recover damages if you hold less than 51% of the fault, but your percentage of fault reduces your compensation.

For example, assume you hold 20% responsibility for a car accident. If awarded $100,000, you would receive $80,000 after the reduction.

However, if you hold 51% or more of the fault, you cannot recover damages.

Two cars with crumpled front ends after a collision on a suburban street, showing visible damage and debris.
A moment’s impact can lead to months of recovery—know your rights after a car accident.

Do I Need A Personal Injury Lawyer?

While not legally required to hire an attorney, having an experienced personal injury lawyer can significantly improve your case. Personal injury attorneys can:

Investigate

Investigate your claim and gather evidence.

Negotiate

Negotiate with the insurance company to maximize your settlement.

Value

Handle settlement negotiations to avoid undervalued offers.

Representation

File a lawsuit if necessary and represent you in court.

Insurance companies often try to deny or minimize claims. A personal injury lawyer can protect your rights and fight for fair compensation.

How to Protect Your Personal Injury Claim

If you believe you have a personal injury case, take these steps immediately:

Seek Medical Attention

Your health comes first, and medical records strengthen your claim.

Document Everything

Take photos, gather witness statements, and keep reports.

Avoid Social Media

The insurance company may use your posts against you.

Consult an Attorney

A skilled personal injury lawyer can evaluate your case.

Wrap Up

If another party’s negligence caused your injuries, you may have a personal injury case. An experienced personal injury lawyer can help you understand your rights.

Get a Free Consultation Today

If you or a loved one suffered an injury, contact our offices 24/7 at (215) 609-4183 for a free consultation. Our experienced law firm will review your case and help you determine the best path forward. Don’t wait—protect your rights today.

A private investigator reviews an injured claimant’s social media posts on a laptop, searching for evidence to dispute a Pennsylvania workers’ compensation or personal injury claim. Insurance companies often use social media surveillance to challenge injury severity in PA workers’ comp and personal injury cases. Injured workers should use caution with what they share online to protect their claims.

Private Investigators in PA Workers’ Comp & Personal Injury

Do Insurance Companies Use Private Investigators In Pennsylvania Workers’ Comp and Personal Injury Cases?

Yes, employers, insurance companies, and defense attorneys frequently hire private investigators—or private detectives—for cases involving workers’ compensation insurance and personal injury claims. They aim to gather evidence that may reduce or deny claims. Ultimately, they want to save the insurance company money.

This may feel intrusive and wrong, but insurance companies commonly use this tactic to challenge claims. While recovering from a work-related injury or a car accident, knowing how surveillance works can protect your claim.

Insurance companies often use surveillance on injured workers and accident victims. Particularly, when claims involve long-term disability or pain and suffering.

Insurance adjusters use private investigators to catch claimants doing things that may seem inconsistent with their reported injuries. However, these investigations rarely provide a full and accurate picture. Investigators can misinterpret or take surveillance out of context.

Insurance companies also use investigators to closely examine medical records, employment history, and social media activity. If they find any inconsistencies, they may dispute the severity of injuries or even accuse claimants of insurance fraud.

Injured workers and accident victims must watch what they say, post online, and do in their daily lives. Investigators could misconstrue even simple actions like playing with a child in the yard or carrying a grocery bag. The responsible party’s insurer will use this to defend a claim.

How Do Private Investigators Conduct Surveillance in PA Injury Cases?

Surveillance often occurs when least expected—during routine tasks such as:

  • Grocery shopping
  • Walking a pet
  • Attending social events
  • Driving or running errands

A private detective employs several methods to monitor injured workers and accident victims, such as:

Video and Photo Surveillance

Capturing footage of a claimant’s physical activities in public places.

Social Media Watching

They review public posts, photos, and videos to find evidence that could contradict an injury claim.

Background Checks

Investigators look at employment history, previous claims, and medical records to detect inconsistencies.

Neighbor and Witness Interviews

They may speak with neighbors, coworkers, or friends who may give information about the injured person’s daily activities.

Insurers use these tactics to reduce or deny benefits by trying to prove a claimant exaggerated their injury.

A private investigator hides in a tree, using binoculars to spy on an injured worker with a cast and crutches in a Pennsylvania neighborhood. Insurance companies often use surveillance like this in PA workers’ compensation and personal injury claims to challenge the severity of injuries. Understanding how private investigators operate can help injured workers protect their legal rights.
Knowing how private investigators operate can help injured workers protect their legal rights.

What Do Private Investigators Look For In Workers’ Comp Cases?

The Department of Labor and Industry oversees Pennsylvania workers’ compensation law. An injured worker must prove they suffered a work-related injury that prevents them from performing their job duties. A private detective looks for evidence that may go against this, such as:

Exceeding Physical Restrictions

If a doctor limits mobility, but an investigator records a worker lifting heavy objects, the insurer may deny benefits.

Engaging in Recreational Activities

Playing sports, jogging, or performing strenuous tasks can raise red flags for insurers.

Returning to Work Without Reporting It

Some injured workers attempt to work side jobs while receiving workers’ compensation coverage, which investigators may uncover.

How Do Private Investigators Affect PA Personal Injury Cases?

In personal injury cases, insurers use surveillance to dispute claims of pain and suffering. They search for:

Contradictory Physical Activity

Insurance companies often argue an exaggerated injury. For instance, if a claimant says they cannot walk for long periods, but appears active at a public event.

Social Media Evidence

Insurers may use photos or videos of an active lifestyle to challenge a personal injury claim.

Daily Activities

Insurers may misinterpret simple tasks like carrying groceries or lifting a child. They will then use this to try to prove injury exaggeration.

Insurance companies may also request medical records to challenge a claim. They compare surveillance footage with documented injuries to find any inconsistencies that could weaken a case.

Surveillance cannot prove pain or the lack of pain. However, insurers will try to use it to reduce or deny compensation.

Can Private Investigators Legally Conduct Surveillance?

Under Pennsylvania workers’ compensation law and personal injury statutes, yes. Although, private investigators must follow legal guidelines:

No Trespassing

They cannot enter private property without permission.

No Filming Inside Homes

Filming can only occur in public spaces.

No Harassment

Repeated, aggressive monitoring may violate the law.

Public Social Media – Fair Game

Insurers can legally use anything shared publicly as evidence.

While insurers may request medical records, they must follow privacy laws. Any unauthorized access to medical records could violate legal protections. If surveillance crosses legal boundaries, a court may rule it inadmissible.

A private investigator reviews an injured claimant’s social media posts on a laptop, searching for evidence to dispute a Pennsylvania workers’ compensation or personal injury claim. Insurance companies often use social media surveillance to challenge injury severity in PA workers’ comp and personal injury cases. Injured workers should use caution with what they share online to protect their claims.
Injured workers should use caution with what they share online to protect their claims.

How Can Injured Workers & Accident Victims Protect Their Claims?

If you file a personal injury case or workers’ comp claim, take these steps to protect yourself:

Follow Medical Advice

Adhere to doctor’s recommendations.

Be Aware of Public Activity

Always assume investigators may monitor you in public spaces.

Limit Social Media Sharing

Avoid posting updates that insurers could misinterpret.

Inform Family and Friends

Ask them not to discuss your injury or case details.

Monitor Your Medical Records

Make sure they accurately reflect your injuries and treatment.

These tips can help to prevent an insurance company from using misleading evidence against you.

What To Do If You Suspect Surveillance?

If you notice a private detective monitoring you:

Stay Calm and Follow Medical Restrictions

Do not alter your behavior; just stick to your doctor’s advice.

Document Suspicious Activity

Record vehicle descriptions and license plates of unknown cars near your home.

Consult a Lawyer

If the surveillance feels excessive or intrusive, seek legal advice. A skilled attorney can challenge surveillance tactics and ensure protection of your rights.

How Long Can A Private Investigator Monitor Me?

In workers’ comp cases, claimants must file within three years from the date of the injury. Insurers may continue surveillance as long as the injured worker receives benefits. 

In personal injury cases, claimant’s must file within two years from the date of injury. Surveillance may continue throughout the duration of the case. 

Although surveillance varies, it often peaks at critical moments, such as:

Shortly After Filing a Lawsuit

The insurance company may try to gather early evidence.

Before an Independent Medical Exam (IME)

Investigators look for inconsistencies before a doctor evaluates a claimant.

Near Settlement Negotiations

Insurers may attempt to reduce payouts with last-minute surveillance.

Insurance companies may also continue to review medical records for any contradictions in a claimant’s reported condition.

Wrap Up

Private investigators often play a role in PA workers’ compensation and personal injury cases. They aim to find evidence that helps insurance companies, often at the expense of the victims.

Surveillance remains legal within limits, but claimants can take steps to protect themselves. Follow medical restrictions, stay mindful of activity in public, monitor medical records, and talk to a lawyer. An experienced Pennsylvania personal injury lawyer and/or knowledgable workers’ compensation lawyer can help protect your rights. Don’t go it alone, get the compensation you deserve.

Give Us A Call

If you suffered an injury and think you have a case, let us help! Reach out to our offices 24/7 at (215) 609-4183 for a free consultation.

Termination Or Cessation Of Workers’ Compensation Benefits

Termination Forms

Workers’ compensation insurance provides benefits crucial for injured workers. Circumstances can arise where these benefits may cease or terminate. Knowing the processes and reasons around the termination of benefits can help injured workers with their workers’ compensation case.

Pre-Litigation Forms

Agreement To Stop Weekly Workers’ Compensation Benefits (Final Receipt) – LIBC-340

Also called a “Final Receipt.” The worker signs this form in agreement to stop receiving workers’ comp benefits. By signing this form, the worker may terminate benefits. But, the insurance company may still cover medical expenses related to the work injury.

Supplemental Agreement For Compensation – LIBC-337

Known as the “Supplemental Agreement.” The worker and employer use this form to agree to adjust the benefits. If the worker’s disability has ceased, this form could terminate both indemnity and medical benefits.

Litigation Forms

Petition To Terminate Compensation Benefits – LIBC-378

Employers use this form to request the termination of benefits. A workers’ compensation judge decides this petition.

Physician’s Affidavit of Recovery – LIBC-497

A doctor completes this affidavit to declare an injured worker fully recovered and no longer in need of benefits. 

Injured worker celebrating full recovery, standing confidently with a cast and crutches in a workplace environment, with a sunny sky symbolizing a positive and bright future.
While employers try to stop benefits, injured workers have options.

What Causes Workers’ Comp Benefits To Terminate?

Full Recovery

Benefits terminate when an injured worker reaches full recovery. Substantial medical evidence must show the full recovery. An independent medical examination (IME) often provides support for this conclusion. This typically requires a physician’s affidavit or the worker’s signed final receipt.

Specific Scenarios For Fatal Claims

Meretricious Relationship or Prostitution:

Benefits can terminate if the dependent engages in a meretricious relationship or lives a life of prostitution.

Remarriage or Change in Dependency Status:

Death benefits for dependents may stop upon remarriage, death, or a change in the dependency status. For example, a widower who remarries can lose their benefits.

What Causes Workers’ Comp Benefits To Cease?

Death From Unrelated Causes

If an injured worker dies from causes unrelated to the workplace injury, the obligation to pay benefits typically ends. However, specific loss benefits may still apply.

Running Of The Statutory Period For Partial Disability

Workers’ compensation benefits for partial disability have a maximum statutory period of 500 weeks. Once this period ends, the benefits will cease by law.

Pre-Litigation Procedures

Final Receipt

A final receipt refers to a signed agreement in which the employee agrees to stop receiving benefits. Even after signing a final receipt, the insurance carrier may still pay reasonable and necessary medical expenses.

Supplemental Agreement

Both parties can agree to terminate benefits through a supplemental agreement. It must include a statement that the worker’s disability has ended.

Agreement For Compensation

Both the worker and employer sign this type of agreement. It can include terms that terminate benefits if it clearly states the end of disability.

Two people shaking hands over a table with documents and a pen, symbolizing a successful workers' comp agreement in a professional office setting.
Sometimes workers’ compensation claims resolve with an agreement

Litigation Process For Terminating Benefits

Burden Of Proof

In litigation, the insurance company bears the burden of proof to show that the worker’s disability has ended. This requires medical evidence. It must show a full recovery and the ability to return to work without restrictions.

Key Points In Proving Full Recovery

  • Medical Opinions: The insurance carrier must present medical opinions that unequivocally state the worker has fully recovered.
  • Employee’s Condition: The employer must prove that any current disability does not relate to the work injury.

Termination Of Lifetime Benefits

Full Recovery

An injured worker no longer has entitlement to benefits once fully recovered. Employers must obtain a final receipt or file a petition for termination to formalize this.

Partial Recovery

Even if an employee has partially recovered, benefits may still terminate. This may happen if proven that the employee’s current condition does not relate to the work injury.

Termination Not Proper

Benefits cannot terminate solely based on the worker’s ability to return to work. The evidence must show that all disability related to the work injury has ceased.

Workers’ Comp Lawyer

Injured workers should know their rights and the evidence needed to challenge or accept the termination of their benefits. If you receive a termination, you need to speak with a Pennsylvania workers’ compensation lawyer. They can help in dealing with the insurance company, filing forms, and representing you before a workers’ compensation judge.

A knowledgeable lawyer can help you handle your workers’ compensation claim, ensuring you receive the benefits you deserve. For personalized help, reach out to our offices 24/7 for a free consultation  (215) 609-4183.

Independent Medical Examinations & Impairment Ratings

Injured workers in PA should know some of the procedures they may face during their claim. Certain procedures can determine the extent of the injury, the ability to work, and the compensation received. Here, we will cover Independent Medical Examinations (IMEs), expert interviews, and Impairment Rating Evaluations (IREs).

What Does Independent Medical Examination (IME) Mean?

An Independent Medical Examination (IME) refers to a medical evaluation performed by a doctor chosen by your employer or their insurance company. An IME aims to obtain an objective assessment of the medical condition following a work-related injury. Research shows these exams tend to favor the employer much more than a treating physician.

Many stakeholders report these examinations as barely an exam and not independent. But, employers have the right to request that injured workers undergo an IME at a reasonable time and place. This exam may allow the employer to dispute the extent of the injury and any ongoing medical treatment. It also allows them to challenge the worker’s medical restrictions.

@thwesq Replying to @laurencepatterso8 unfortunately, the financial incentive for these doctors seems too far out weigh any moral compass they may have had. Independent medical exams are not independent, and they are barely a medical exam. #workersrights #workerscomp #lawyer #workinjurylawyer #workinjury ♬ original sound – Tom Wing | Workers Comp Lawyer

Why Does An Employer Request An IME?

Employers often request an IME to gather a second opinion about the medical condition from a friendly party. An IME can provide evidence on the diagnosis, the current treatments, and the prognosis for returning to work. This can save the employer money on claims. IMEs help employers to challenge parts of an employee’s claim.

What If I Refuse To Attend An IME?

Refusing to comply with an order for an IME can lead to serious consequences. The Pennsylvania Workers’ Compensation Act addresses this. If you miss an IME without reasonable cause, you risk losing your benefits during this period. This means they could suspend wage loss and medical benefits.

How Often Can My Employer Request An IME?

The frequency of IMEs can vary. Typically, employers may request an IME every six months. This can depend on the circumstances of the case and the discretion of the Workers’ Compensation Judge (WCJ).

May I have My Own Doctor Present During An IME?

Yes, you have the right to have your own healthcare provider there during the IME. However, your doctor’s role remains limited to observing the exam. They cannot interfere, videotape or audiotape, question the examiner, or help you in responding to questions. Your lawyer may hire a nurse to attend the exam as well.

Independent Medical Examination (IME) scene showing a patient being examined by a doctor in a medical office, with medical instruments, records, and anatomical charts visible in the background, representing the detailed assessment process for workers' compensation claims.
A patient examined by a doctor for a workers’ compensation claim.

Understanding Expert Interviews

What Happens At A Vocational Expert Interview?

Vocational expert interviews assess the injured worker’s earning power when receiving workers’ comp. They look at their ability to return to work. They also determine the type of work they can perform, given the injury. The insurer can require the worker to submit to an interview with a vocational expert.

Why Conduct Vocational Expert Interviews?

The main purpose of a vocational expert interview involves assessing the worker’s earning capacity. They consider the worker’s education, work experience, skills, and current labor market conditions. Then, they will determine the types of jobs that might suit the injured worker.

The findings from the vocational interview can impact the continuation or modification of workers’ comp benefits.

What Qualifications Does A Vocational Expert Have?

Vocational experts must adhere to the criteria set forth by the Bureau of Workers’ Compensation. They must have a Commission on Rehabilitation Counselor Certification and one year of experience analyzing labor market conditions. Or, a bachelor’s degree and work under the direct supervision of someone with these qualifications.  

What If I Refuse To Attend A Vocational Expert Interview?

Refusing to attend a vocational expert interview can result in the suspension of benefits. The WCJ has the authority to enforce attendance at these interviews. They can also suspend benefits for failure to comply without reasonable cause.

Impairment Rating Evaluations (IREs)

What Does IRE Mean?

An IRE refers to a medical assessment used to determine the extent of permanent impairment from a work injury. An IRE aims to establish the degree of the body impairment and classify the disability status.

IREs must use the sixth edition of the American Medical Association Guides to the Evaluation of Permanent Impairment. The results of an IRE can impact the duration and amount of workers’ comp benefits.

How Does An IRE Affect Disability Status?

The IRE’s outcome determines whether the disability status remains classified as totally disabled or changes to partial disability. If the impairment rating hits 35% or higher, total disability benefits will continue.

If the impairment rating is less than 35%, the status will change to partial disability. This change means receiving partial disability benefits. While the name of the benefit changes, the amount of the benefit stays the same. However, an injured worker can only receive partial disability benefits for a maximum of 500 weeks.

What If I Disagree With The IRE Results?

If you disagree with the results of an IRE, you may be able to appeal the decision. This would involve filing a petition for review with the Bureau of Workers’ Compensation or hiring your own expert.

Patient reaching Maximum Medical Improvement (MMI) in a medical office, with a doctor explaining the stabilized condition using medical charts and x-rays. The patient looks relieved and hopeful, highlighting the recovery progress and thorough discussion about the condition.
Patient reaching Maximum Medical Improvement (MMI) in a medical office.

Reaching Maximum Medical Improvement (MMI)

What Does MMI Mean?

Maximum medical improvement (MMI) refers to a vital point in the recovery. It means the medical condition has stabilized and will likely not improve that much with further treatment.

An injured worker must reach MMI before an impairment evaluation. It can also impact decisions regarding your workers’ compensation claims.

Understanding the Editions of the Guides

The American Medical Association Guides to the Evaluation of Permanent Impairment, often referred to simply as the “Guides.” They serve to assess the extent of an injured worker’s permanent impairment.

Different editions of the Guides appear over time, each incorporating updated medical knowledge and assessment techniques. The sixth edition, currently used for IREs in PA, includes comprehensive criteria for evaluating various types of impairments and determining the overall impairment rating.

Wrap Up

Know your rights. For help with your workers’ comp case, consult with a workers’ compensation lawyer. An experienced lawyer can help secure the benefits you need to support your recovery and future well-being. For a free consultation, reach out to our offices 24/7 at (215) 609-4183.

How Does Workers’ Comp Work in PA?

Workers’ compensation ensures employees receive financial support and medical care in cases of work-related injuries or illnesses. This blog post aims to explain how workers’ comp works under the Pennsylvania Workers’ Compensation Act. We will only focus on PA workers’ compensation laws here.

Understanding Workers’ Compensation in Pennsylvania

What is Workers’ Compensation?

Workers’ comp is a state-mandated insurance program, designed to protect employees. These protections cover employees with injuries and illness caused by their work.

In PA, the Pennsylvania Bureau of Labor and Industry administers workers’ comp. This program helps employees get compensation for their medical expenses and lost wages. It also protects employers from lawsuits related to workplace injuries.

Am I Covered?

PA requires nearly all employers to provide workers’ comp coverage to their employees. This includes both private and public sector employers. However, some exceptions exist, such as sole proprietors and certain agricultural workers.

Types of Injuries Covered

PA workers’ compensation covers a broad range of work-related injuries and illnesses. This includes accidents like slips and falls. It also covers conditions that develop over time, such as repetitive stress injuries or occupational diseases.

The Workers’ Compensation Claim Process

Reporting an Injury

When an employee suffers an injury or work-related illness, they should promptly report the injury to their employer.

Reporting must occur within 21 days of the injury or diagnosis to qualify for retroactive back pay. If the employee fails to report the injury within 120 days, they lose all entitlement.

This means the end of the workers’ comp claim and the employee will not qualify for any workers’ comp benefits. Reporting ensures that the claims process can begin in a timely manner.

Seeking Medical Treatment

Workers’ comp covers all reasonable and necessary medical expenses related to the work-related injury or illness. Employees have the right to choose their own healthcare provider.

But, there can be limitations within the first 90 days of a claim. Often, that would necessitate an employee to receive medical treatment through an employer’s approved panel of doctors. The panel may allow the injured worker to seek medical treatment without delay.

Filing a Claim

When loss of work from an injury exceeds/expects to exceed more than 7 days, the employer must file a formal workers’ compensation claim. The Pennsylvania Bureau of Workers’ Compensation receives this notification. The employee receives notification and the claims process begins.

Investigation

Once filed, the employer or its insurance company will investigate the claim and the circumstances surrounding the injury. Interviews of both the employer and the injured employee may happen during this process.

With an accepted claim, the injured employee will receive compensation and notice in the mail. With a denied claim, the injured worker would need to file the appropriate petition.

Benefits

Workers’ comp benefits include medical benefits, wage loss benefits, and specific loss benefits.

Medical benefits cover all reasonable and necessary medical expenses related to the injury or illness. Wage loss benefits provide compensation for lost wages during the recovery period. Temporary Total Disability (TTD) benefits also refer to wage loss benefits.

When an injured worker has wage loss, while continuing to work, Temporary Partial Disability (PTD) benefits would apply. Specific loss benefits provide for permanent disfigurement or loss of use or loss of a body part.

Legal Aspects of Workers’ Comp in PA

Employer Responsibilities

Employers have several responsibilities in workers’ compensation.

They must carry proper insurance coverage. They must post notices about workers’ comp in an obvious location.

They must accept or deny liability within 21 days of the injury. They must send written notice of the claim’s acceptance or denial to the injured worker.

Injured employees should not fear reporting their injuries. Employers also cannot retaliate against employees for filing a workers’ compensation claim.

Employee Rights

Employees have certain rights in workers’ compensation in PA.

They have the right to receive medical treatment for their work-related injuries. They have the right to receive wage loss benefits if they are unable to work or are working at a wage loss. They have the right to appeal decisions on denied claims.

Employees should understand their rights and exercise these rights to protect their interests.

Dispute Resolution

Disagreements can arise during the workers’ comp process. With a denied claim, an employee can request a hearing before a workers’ compensation judge. This allows both parties to present evidence and arguments, and the judge will make a decision.

The Workers’ Compensation Appeal Board and the Commonwealth Court, if necessary, hear appeals.

Denied Workers' Compensation Claim Process Diagram - Detailed visual guide illustrating the step-by-step appeal process for denied workers' comp claims in Pennsylvania, featuring the initial denial notice, Workers' Compensation Judge review, Workers' Compensation Appeal Board examination, Commonwealth Court appeal, and potential PA Supreme Court review. Ideal for individuals navigating the complexities of workers' compensation denials.
How the court process works for Workers’ Comp

Attorney Involvement

An attorney, though not required, can add serious benefit. When complex cases and claim disputes arise, a workers’ comp attorney knows what to do.

Lawyers can provide legal guidance and protect the rights of the injured worker. They can calculate the average weekly wage, making sure injured workers receive the compensation they deserve.

Attorneys can protect the injured workers, making sure they do not return to work until medically able. They can make sure the notice of compensation payable lists all injuries include.  Lawyers can also make sure your medical bills do not end up on your credit report.

Questions and Concerns

Will My Employer Fire Me for Filing a Workers’ Comp Claim?

PA law prohibits employers from firing or retaliating against employees for filing workers’ compensation claims. If an employee faces such retaliation, they have the right to take legal action.

How Long Can Workers’ Comp Benefits Last?

The duration of workers’ compensation benefits in PA varies depending on the circumstances of the injury or illness. Temporary Total Disability (TTD) benefits may be available as long as the employee remains unable to work. Other benefits may have different durations.

Can I Choose My Doctor?

Employees have the right to choose their own healthcare provider, from the list of approved providers, within the first 90 days of a claim. However, the employer must follow all its obligations for this to apply. After the initial 90 days an employee can treat with any medical provider. This allows injured workers to receive treatment from a trusted medical professional.

Will Workers’ Comp Offer a Settlement?

Many workers’ comp cases settle for a lump sum. A lawyer can often help to negotiate a higher settlement. Use our free settlement calculator to estimate the value of your case online.

@thwesq Will workers comp offer a settlement without a lawyer? #theymight #lawyer #pennsylvania #getpaid #workinjury ♬ Breaking News Background Music (Basic A)(1001538) – LEOPARD

Conclusion

Workers’ comp helps employees receive financial support and medical care after an injury or illness caused by their work.

Understanding how workers’ comp works in PA is essential for both employers and employees. This upholds everyone’s rights and responsibilities under the program.

Talk to a workers’ comp lawyer today for a free case evaluation. Let us answer your questions about your rights in your workers’ compensation claim.