Workers’ Comp FAQs

Most times, the workers’ compensation insurance company for your employer pays your wage loss benefits and your medical bills emanating from a workplace injury or illness. Sometimes, employers are self-insured, so benefits are paid through a TPA, or third-party administrator, but come directly out of the company’s pocket. There are also occasions that, for certain reasons, an employer will pay you full wages in lieu of workers’ compensation benefits. If your employer does not carry workers’ compensation insurance and is not insured, you may be eligible to receive comp benefits from the State Workers’ Insurance Fund.

The Pennsylvania Workers’ Compensation Act applies to the vast majority of employers, including nonprofit corporations, unincorporated businesses and employers that have only one worker.

Most workers are covered through Pennsylvania’s workers’ compensation system. Some workers are eligible for other state or federal compensation programs — for example, federal civilian employees, railroad workers, longshoremen and shipyard and harbor workers. In addition, exemptions may apply to volunteer workers, agricultural laborers, casual employees and domestic workers. Corporate executive officers may sometimes waive coverage.

Injuries, illnesses or diseases you suffer at your workplace or while performing a job-related duty or activity are typically covered under the workers comp umbrella. Additionally, “new” injuries, as well as material aggravations of prior conditions, are considered work-related injuries in Pennsylvania. Workers’ compensation does not pay benefits for intentionally self-inflicted injuries or those injuries caused by an employee’s violation of the law or what is called a “positive work order.” In addition, an employee may be denied coverage for injuries caused by intoxication.

An occupational disease is an illness that is caused by or aggravated by your workplace conditions and that occurred within 300 weeks of your last date of employment in the job that subjected you to exposure to the hazardous substance(s). However, you may be subject to less-restrictive time limitations for some diseases.

Repetitive stress injuries can arise from performing the same task repeatedly and continuously. Carpal tunnel syndrome, for example, is a common repetitive motion injury related to daily typing. If your employment duties lead to this type of injury, you may be entitled to compensation.

You may be denied benefits if you fail to notify your employer in a timely manner of your job-related accident or illness. Our attorneys explain what to do after an injury at work and how to best protect your health and right to wage loss and medical benefits.

Typically, an employee must give notice within 120 days of the date of the accident. However, if notice is given beyond 21 days, it can affect the period for which an injured worker is eligible for benefits. We recommend that you give notice of a work accident or injury to your employer immediately, in order to avoid delays in receiving compensation and potentially reduce the resistance you will face from the employer and workers compensation insurance company to issuing benefits. Again, though, the rules and laws that govern the notice requirements in Pennsylvania workers’ compensation law are complex, so the best thing to do is give us a call to have your questions answered fully in the context they arise.

Typically, you have up to three years from the date of your injury to formally contest a Notice of Workers Compensation Denial issued by your employer or the insurance company. However, the sooner you take appropriate measures to enforce your right to benefits, the better, for many reasons. At Georgelis, Larsen & Sabatino Injury Law Firm, P.C., we can explain all of your options to you and answer all of your questions through one of our free and no-obligation case reviews and evaluations.

The amount of compensation you are entitled to depends on numerous factors, including, but not limited to, the extent of your injuries, the length of your disability and the salary you earned before you were injured. Our top injury and accident lawyers will thoroughly analyze the specific and unique circumstances of your workers comp claim for no charge or obligation, so we can give you an accurate indication of the income loss and medical benefits you should expect to receive.

Possibly. In most occupational disease cases, your illness or disability must occur within 300 weeks of the date of last employment in the job that exposed you to a dangerous condition. In addition, you have up to three years from the date of your injury or disability to file your petition. To collect benefits for certain lung diseases, you must have worked in an occupation with a silica, coal or asbestos hazard for at least two years during the 10 years preceding your disability.