Thousands of Pennsylvania workers suffer work-related injuries every year. To protect these injured employees, Pennsylvania state law requires nearly all employers to provide workers’ compensation benefits. Workers’ compensation
is designed to not only pay for an injured worker’s medical bills, but also provide wage-loss benefits if they are unable to work for a period of time following an accident or illness.
That said, “workers’ comp can very confusing to navigate through,” warns Mitch Dugan
, an attorney with Dugan & Associates law firm in Pittsburgh.
The Workers’ Compensation System Process
The flip side of workers’ compensation laws is that employees generally lose their right to sue for damages through a personal injury claim, even when the employer’s negligence was responsible for the accident. However, you may still file a lawsuit if your employer fails to provide workers’ compensation coverage (which is illegal), denies your workers’ compensation claim, or suspends or terminates your benefits.
The most important thing to remember is that, if you have suffered a workplace injury, you need to inform your employer as soon as possible. An employer is not required to provide benefits until it is notified or aware of your job-related injury. By law you must give notice within 120 days of the job injury.
If you disagree with a workers’ compensation case decision made by your employer, you have the right to file a petition with the Bureau of Workers’ Compensation of the Pennsylvania Department of Labor & Industry. This is technically an administrative proceeding rather than a traditional civil court lawsuit. A special workers’ compensation judge (WCJ) will review your petition, hold a hearing, and issue a decision granting or denying the relief you seek.
“I wouldn’t recommend anyone go to any kind of court without a lawyer,” Dugan says. “Some people are under the mistaken belief that all they have to do is show up, tell their side of the story and everything will be OK. That’s clearly not the case. Workers’ compensation is a full-blown trial system, although it’s done in steps instead of a one-day, one-trial scenario.”
If you are dissatisfied with the WCJ’s ruling on your claim, you can seek further review before the Workers’ Compensation Appeal Board. Beyond that, you can appeal to the Commonwealth Court, Pennsylvania’s intermediate appellate court, and in some cases, up to the Pennsylvania Supreme Court.
“The insurance company is paid by the employer. They have lawyers; they know the system. You may be in over your head. Their team might run circles around you,” Dugan says. “Many people call after the fact and say, ‘I settled my case, but this and this is a problem,’ but it’s too late. And in my experience, nine times out of 10 we could have gotten a better offer. Insurance companies against an unrepresented worker usually lowball them.”
Hiring a Workers’ Compensation Attorney
When workers’ compensation disputes arise, it can lead to lengthy and complex litigation. As described above, there are multiple potential stages of administrative and judicial review for an employee’s injury. Obviously the employers—and their workers’ compensation insurance carriers—will have experienced attorneys helping them at every stage of this process.
For that reason, if you expect any sort of problem with your case, it is a good idea to at least speak with a licensed Pennsylvania workers’ compensation attorney
who has experience in dealing with employers and insurers. If nothing else, you want to devote your full attention to healing from your injuries, not dealing with administrative paperwork and possible litigation.
If you’re worried about the cost, attorneys like Dugan do not charge fees up front. They are paid when your case is resolved, and their fees are legally set at 20 percent.