What To Do If You Are Injured At Work
You should immediately notify your supervisor or boss that you were injured on the job. It is important to give notice to your employer of a work injury within 21 days of the date of the injury. If you do not give notice of your injury to your employer within 120 days of the date of the injury, you will likely not be entitled to compensation. Verbally providing notice to your employer is enough to satisfy the notice requirements under the Pennsylvania Workers’ Compensation Act but it is often better to complete and file an accident/incident report with the employer. If you are in a union, it is a good idea to inform your union representative of your injury.
Once you have given notice of your work injury to your employer, it and its workers’ compensation insurance carrier have 21 days to inform you whether they are accepting your injury as work-related. If your injury is accepted, you must treat with one of the employer’s designated healthcare providers (from a valid list) for 90 days from the date you first sought medical treatment for your injury. If your employer and its workers’ compensation insurance carrier deny your injury is work-related, you can treat with whomever you wish, as your employer and the workers’ compensation insurance carrier are not responsible for payment.
With an accepted claim, you will be entitled to wage loss benefits under the Workers’ Compensation Act if your disability due to a work injury lasts longer than 7 days.
If your injury is denied as work-related, you will need to file a Claim Petition within 3 years of the date of injury in order to be able to obtain workers’ compensation benefits for your injury. This 3-year time period also applies should your employer or its workers’ compensation insurance carrier not file the proper documents regarding your work injury.
If you have questions about workers’ compensation, call Fritsch Law, LLC for a free consultation at 412-480-8653 or complete our contact form on this site.
What Is A Work Injury
A work injury, entitling an injured worker to benefits under the Workers’ Compensation Act, is defined in Pennsylvania as “an injury to an employee, regardless of his previous physical condition, arising in the course of his employment and related thereto.” 77 P.S. § 411(1). You do not necessarily have to be engaged in actual work at the time of the injury for it to be considered work-related under the Workers’ Compensation Act. It also does not matter who is at fault for the injury. The Workers’ Compensation Act is applicable to all injuries occurring in Pennsylvania.
However, the Workers’ Compensation Act precludes the payment of compensation in the following circumstances: If you intentionally cause your own injury, your injury is a direct result of your violation of law or positive work order, your injury is due to personal animosity, or the injury would not have occurred but for the intoxication of or illegal use of drugs by the injured worker. As there are nuances involved in these exclusions, it is always a good idea to consult with a knowledgeable attorney. Feel free to call Fritsch Law, LLC for a free consultation at 412-480-8653 or complete our contact form on this site.
Which Doctor Do I Treat With For My Work Injury?
First, if your employer and its workers’ compensation insurance carrier have not properly accepted your injury as work-related (they have 21 days from the date you give notice that you sustained an injury at work to issue the proper documentation regarding their decision to accept or deny your injury as work-related), you can treat with any doctor of your choice. You will likely need to bill your health insurance carrier during this period. You will also have to file a successful Claim Petition within 3 years of the date of the injury in order to be entitled to future workers’ compensation benefits for the injury.
Now, if your injury is properly accepted as work-related, you must treat with your employer’s providers for the first 90 days, assuming your employer provides you with a valid list of health care providers from which to choose. The 90 days begins on the date you first seek treatment for your work injury. Your employer must pay for the treatment if the treatment is by one of its listed providers and the treatment is reasonable, necessary and causally-related to the work injury. You can seek emergency medical treatment with any provider but once the emergent need for treatment has passed, non-emergent treatment must be given by a listed provider. Once you choose a provider on the list, you may switch to another provider on the list at any time. You do not need to get anyone’s approval to switch providers. If a listed provider refers you to a provider that is not on the list, you may treat with that provider as well. If a listed provider recommends that you undergo surgery for your work injury, you have the right to obtain a second opinion from a provider of your choice. If that opinion is different from the opinion of the listed provider, you choose which course of treatment to follow but if you choose the treatment recommended by the second opinion, your 90 days restart.
It is important that your employer provide you with a valid list of health care providers from which to choose to treat with for your work injury. If the list is not valid, then you are free to seek treatment for your work injury with any health care provider of your choice. If you are provided a valid list and choose to see a provider not on the list, it is possible that neither the workers’ compensation carrier nor your health insurance will pay for the treatment provided by that provider.
The list of health care providers that you receive from your employer must meet all of the following requirements in order to be a valid list: 1. There must be at least 6 health care providers on the list; 2. At least 3 of the providers must be physicians; 3. No more than 4 of the providers may be coordinated care organizers; 4. The list must include the providers’ names, addresses, phone numbers and area of medical specialty; 5. The providers must be geographically accessible and have specialties that are appropriate based on the anticipated work-related problems of the employer’s employees; and 6. The list must specify if any of the providers are employed, owned or controlled by your employer or its workers’ compensation insurance carrier.
After the first 90 days, you have the right to seek treatment with any provider of your choice. Your employer and its workers’ compensation carrier remain responsible to pay for treatment that is reasonable, necessary and causally-related to the work injury. You have a duty to inform your employer if you receive treatment from a provider not on the employer’s list. You must give notify your employer within 5 days of your first appointment with a new provider. Your employer and its workers’ compensation insurance carrier does not have to pay for treatment until you provide this notice.
Feel free to call Fritsch Law, LLC for a free consultation at 412-480-8653 or complete our contact form on this site.
The information contained on this website is not legal advice nor legal opinion and should not be relied upon. Nothing on this website is intended to create or establish, and does not constitute, an attorney/client relationship. This site is legal advertising.
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