When filing for benefits under Workers’ Compensation in Pennsylvania, the bulk of the responsibility rests with the employer and the insurer. As the injured employee, your responsibility consists of reporting the injury to your employer, seeing a doctor, and filing the necessary paperwork. If the claim is accepted, the process moves forward and you’ll receive full or partial compensation based on your injury and schedule of wages. If the Workers’ Compensation claim is denied, you have the right to challenge the denial and continue to pursue compensation.
The Most Important Step
As soon as you believe you have been hurt, report it to the appropriate individual. Do not delay in this matter as it could have a negative impact on your claim. Once you have notified your employer, you must see a doctor. If your employer has accepted your claim and has posted a list of doctors, you are obligated to visit one of them. If you are not satisfied with a particular doctor’s work, you can see another doctor on the list. After ninety days, or if your employer has not posted a list, you can seek treatment from a doctor of your choosing.
Other than reporting the injury, filling out the forms, and seeing the doctor, the rest is up to the employer. He or she must respond to all claims and meet all of the requirements within 21 days.
Receiving Compensation
Once your employer has accepted your claim, he or she has a few options.
- The claim can be accepted with a Notice of Compensation Payable issued. This means your employer has accepted your claim, no further investigation is necessary, and payments will begin and continue until you return to work.
- The claim can be accepted with a notice of Temporary Compensation issued. This allows the employer to extend the investigation period an additional 90 days if necessary. However, payments will begin and continue until the claim is fully accepted or denied.
- The claim can be denied. In this case, the employer rejects the compensation claim and no payments are made.
In the first two instances, you will receive the benefits to which you are entitled. Although working with a bureaucracy can be a little frustrating, you should make sure that you file all the paperwork and provide all of the necessary information.
However, if your claim is denied, you still have the right to challenge the decision and continue to seek compensation. Filing a petition with the Workers’ Compensation in Pennsylvania Office of Adjudication signals your desire to pursue the matter further. If you choose this course of action, you should seek legal assistance to make sure that you’re properly represented, prepared, and not mismatched when facing the insurer’s attorneys.
Seeking Workers’ Compensation in Pennsylvania is not a complicated process, unless your claim is denied. If that’s the case, then seeking what you’re entitled to is going to require careful planning, a knowledge of the system, and a lot of paperwork.