Any Pennsylvania employee who is hurt at work is entitled to PA workers' compensation benefits. Even an injury outside of work may give you a right to benefits, if there is a connection between the injury and your work duties. If you were attempting to do something for the benefit of the employer, we can qualify you for payment of medical bills and lost wages. The injury must be "in the course and scope of employment." That standard can be read broadly, and includes some elements of "going and coming" into the workplace, as well as "special missions" outside of the workplace that may have been related to your job.
There is no requirement as to how long you have to work at a given job. Even a trainee, still doing "orientation", on the very first day of a job, will be covered. Just don't expect a new employer to be honest about that.
Workers compensation rights can be very valuable, in many cases giving rise to lump sum settlements valued at several years of wage loss benefits, with six figure settlements not uncommon for injuries with long term effects. For this reason, employers hesitate to acknowledge claims in accordance with the Workers Compensation Act. Insurance companies may work right from the start of a claim to try to limit the value of that claim and to undermine the rights of the injured worker.
Some employers will claim "there are no benefits unless you are disabled more than a week." They may refuse to report your work injury claim to their insurer or to the Bureau of Workers' Compensation, as required under the Act, if they feel they can limit your claim to a short period, or if they expect that you will not consult with an attorney to learn about your real rights.
trust what your employer or their insurance representatives tell you about the claims process or about your rights. Even if they do not lie outright, they will have well-rehearsed ways to "spin" information in ways intended to mislead injured workers, trying to preserve for themselves the maximum control over your claim while at the same denying your rights or ignoring their obligations. If you were injured at work, call the Law Offices of Timothy Kennedy immediately to learn how things are really supposed to work. We will be glad to speak with you, and there is no charge or cost to you.
The fact is, YOUR WORK INJURY GIVES YOU RIGHTS!
The employer and insurer work very hard to limit claims, often very unfairly, in the early days after your injury is reported. At the same time, they may work equally hard to convince you that everything they are doing is above board. They may attempt to reassure you that you will be treated fairly. Your employer's insurance representatives may act as if they are nothing but supportive, but all the while work behind the scenes to treat your very legitimate claim exactly as they would treat an entirely fraudulent claim, even influencing doctors to get them to slant their records to understate your injuries or even to question the credibility of your complaints.
The law itself gives employers many ways to make life difficult for the injured worker. But a worker who knows his or her rights and gets strong legal advice about the obligations of the employer can not only fight back, they can position their claim in a way that forces the employer and insurer to take notice, to play by the rules and to pay
by the rules. Meanwhile, in many cases, the employer need not even know you are being advised by counsel. Our early involvement helps you to shape the dispute in your favor, in much the same way the insurer and those working with them - often including "panel" treating doctors - are at the same time working to shape the case in ways that limit your long-term rights as much as possible.
In truly the vast majority of cases, employers and insurers do things that are contrary to the law, while telling the injured worker they must
go along. They do this to manipulate the claim from day one, to their own advantage and against the rights of the worker. Many employers, and ALL workers compensation insurance companies, are very well-practiced at this. Many will systematically violate or disregard the law and take other steps to twist the law to gain an unfair advantage. They will actively mislead the injured worker to believe that all is well. For example, they may have a "case manager
," often a nurse, contact the worker or even attend medical appointments. The case manager is employed by the insurance company and their only role is to keep you in line so they can influence the medical evidence as much as possible against your interests and rights. They are working to limit the value of your claim.
One big abuse by employers is refusing to even recognize a claim. Most will demand that you go to a "company doctor" -- often unfairly -- while at the same time they fail to take on any formal responsiblity for your claim. It's quite a racket when the employer tells you exactly what doctor or practice to see, has direct contact with that doctor about what they are willing to have that doctor look at, then ignores or disputes your claim based on what that doctor does or does not record.
Your employer and its workers' compensation carrier are directed by law to formally accept or deny your claim within twenty-one days after you report your work injury. A "Medical Only" acknowledgement is available for them to file even if they claim there are no lost wages and only a need for medical treatment. Even if you have a letter or some other acknowledgment from your employer's insurer, if you have not recieved a formal "Notice of Compensation Payable" or "Notice of Temporary Compensation Payable" or "Notice of Compensation Denial" within twenty-one days from the date you reported your injury, you should interpret this to mean that the employer and insurer have denied
your claim "by operation of law" -- even if they are communicating with you and acting as if your claim is still under investigation. Your rights are not recognized, let alone secure, if they have not filed the required documents with the Bureau of Workers' Compensation and served these documents on you. Their failure to issue Bureau documents generally means they intend to sweep your rights under the carpet, while at the same time forcing you to jump hoops for them in ways that help them. That is, they want to limit your rights and force you to meet many prejudicial obligations under the Act (which they will claim means an obligation to treat with their doctors and to accept light duty work at their directives, or even to sign authorizations that give them rights not afforded to them under the Act, etc.) while they themselves take on none of the obligations of the Act and honor none of the rights afforded to you by the Act after a work injury.
When a responsible employer and thier insurer do properly accept a claim, the most common mechanism is a Notice of Temporary Compensation Payable, or NTCP. Unless it is marked "medical only", this document will start you receiving wage loss benefits. But even though you may get a check, an NTCP does not secure your rights and is not worth much more than the paper it is printed on. It includes a disclaimer that it is not
an admission of any liability by the employer or the insurance carrier. It only binds them during the time they decide to keep it in force, up to 90 days from the start of work-related disability. During that time, they will put tremendous pressure on healthcare providers (who most often they have hand-picked) to release you to work in some capacity and also to under-state your injury in ways that will limit your long term rights.
If you remain disabled beyond ninety days and the insurer does not issue a "Notice Stopping" temporary compensation, your right to ongoing benefits will then be far more secure. The law would then require the insurer to produce real evidence of a change in your disability status before they could take away your benefits. Since this only happens after ninety days where the insurer uses the NTCP, you can bet they are watching that deadline. In most instances, if the injured worker has not taken careful steps to secure their own rights, the insurer will simply cut off benefits at or before that ninety day deadline, leaving the injured worker to fight for any long term benefits and the potential right to a lump sum settlement.
Another big trick by insurers is to understate the nature of the work injury in the documents they file. They will often try to call everything a mere "strain" or "sprain" or "contusion" -- when in fact you may have much more significant and long-term pathology.
One other big trick: Employers prefer to push injured workers back to work very
early, no matter how serious the injuries are. The theory is that if you are not losing wages, you wont be able to get an attorney interested in protecting your rights. They may feel that the Bureau will be none the wiser if they fail to report a claim that is initially "medical only". And if they do record the injury that way, they can thereby leave you, the injured worker, with the burden of proof to convince a workers' compensation judge that the injury in fact results in disabilty and loss of wages within the meaning of the Act.
The only way to protect yourself from the games played by insurers as they attempt to position themselves in the early days of a claim is to know your rights
and to know how to act on them.
Call the attorneys of The Law Offices of Timothy Kennedy, PC to discuss the circumstances of your claim. Talk to us about the employer and insurer are doing or about what they are failing to do. Our help early in the claim will cost you nothing yet it can set you up to either avoid an unnecessary legal battle over your rights or set you on a path where, if there must be a legal fight, you are positioned to win early and force the employer's compliance with the law.
Please call us now at 484-453-8144.