What To Expect During A Worker’s Compensation Claim

Worker’s compensation is a type of insurance that provides medical care and financial coverage for a Pennsylvania employee who gets injured during the performance of their work duties. Filing a claim has to be done promptly, both the employer and insurer have to agree the claim is valid, and the employee has to receive treatment from an approved provider to get coverage. An employee can file for work-related health issues including injuries, illnesses, and repetitive stress injuries.

The process is designed to be straightforward, but sometimes it is more complicated when private insurance companies are involved. Insurers do what they can to reduce the amount of money they pay out, which makes it necessary to talk to a personal injury attorney in Media or a specialized lawyer to ensure you get what you are entitled to by law. The following is a look at what you can expect when filing a worker’s compensation claim. 

What Happens After You’ve Reported Your Claim

According to the Pennsylvania Department of Labor & Industry, you have to be disabled for more than seven consecutive days before you start receiving money. The seven days include weekend days, and the benefits can be paid out on the eighth day after an injury is reported. After you’ve been off work for 14 days, you can get paid for the first seven days you were unable to work.

At Katz Injury Law, we emphasize that your health comes first. Even if your injury happened at a job site, you should follow the standard protocol for any injury: go to the hospital immediately. This creates a medical record that prevents the insurance company from arguing that your injury was not work-related or severe.

Health Provider Requirements

You are allowed to use your personal healthcare provider up until the time your employer accepts your claim. After the claim is accepted, you are required to visit a healthcare provider that is listed by your employer or insurance company.

• The Panel List: The list has a minimum of six physicians that you can see for ongoing care.
• The 90-Day Rule: Once you have selected a provider, you are required to see them or another provider on the list for 90 days.
• Changing Providers: Once the 90 days have passed, you can see a provider of your choosing, but you must notify your employer or insurer.

If your injury was caused by a dangerous condition on a property, consulting a slip and fall lawyer in Delaware County can help determine if a third-party claim exists alongside your worker’s comp claim.

How Much Does Worker’s Compensation Pay?

Worker’s compensation pays about two-thirds of your average weekly pay, but it can be offset by Social Security benefits, unemployment compensation, and other income. The duration depends on your impairment rating:

• Total Disability: If you receive a rating of 35% impairment or higher, you can claim compensation for at least 104 weeks before a status review.
• Partial Disability: If you are considered partially disabled or return to work at a lower-paying position, you can receive benefits for up to 500 weeks.

Because these calculations can be complex, it is helpful to have an injury lawyer review your average weekly wage calculations to ensure the insurance company is not underpaying you.

Protecting Your Claim Through Treatment

It is important that you follow your doctor’s orders to the final detail. If you are ordered to attend physical therapy or take specific medications, do so faithfully. Not following your doctor’s orders can give the insurer an excuse to suspend your benefits, arguing that you are not actually as injured as you claim.

Always save all medical documentation, including discharge papers and therapy logs. These documents are essential to your case and serve as proof of your ongoing disability.

Getting Help From Katz Injury Law

The worker’s compensation process in Pennsylvania should be simple, but the insurer may try to undermine your claim. Whether you are looking for the best injury lawyer in Philadelphia or a local advocate in the suburbs, Katz Injury Law is here to help.

When you retain our firm, you are getting representation from a team more than qualified to protect your rights. We have extensive experience fighting for those who received an injury at work. Don’t face the insurance companies on your own. Contact us today to start receiving the justice and financial support you deserve.