Pennsylvania Workers Comp Claims: Eligibility, Filing and Appeals

The Pennsylvania Workers' Compensation Act gives employees the right to have medical expenses and wages paid if they have lost work due to work related illness or job injury. Those who die on the job may also receive benefits, paid to survivors. Private insurance companies pay these benefits or they come from the State Worker's Insurance Fund, or by the employer, themselves if the employer is self-insured.

Pennsylvania Workers Compensation Claims

One should report any injury or illnesses to the employer immediately. The employer needs to know how you injury occurred including the date and place of the injury. If you do not notify the employer, this may delay or cause a denial of benefits. If you lose a day of work, a shirt of a turn of work, the employer will then notify the Bureau of Workers' Compensation with a First Report of Injury form. The employer may accept or deny the claim.

Common Covered Work Related Injuries

Disease, illnesses and injury that are a cause by work receive coverage by workers' compensation. If the injury or death is self inflicted or caused by an employee's violation of the law, illegal use of drugs or intoxication, the claim will not be payable through workers' compensation. Employees must be working, on the clock for injuries to be covered.

Workers Compensation Claim Denials

If an employer denies the claim, this may be due to lack of proof of the incident or reason to believe the claim is fraudulent. In addition, if there is reason to believe the illness or injury did not result on the job, this too could lead to denials. In addition, the Bureau of Workers' Compensation may deny the claim on the grounds of missing or late paperwork, fraudulent activity or because no medical treatment was sought.

Appealing a Claim Denial

If your claim is in denial, report this to the Bureau for further information. You can file a Claim Petition with the bureau directly. This will schedule a hearing before a Workers' Compensation judge who will make the final ruling in the case.

Collecting Pennsylvania Workers Compensation Benefits

Employees receive numerous benefits. Payment for lost wages are paid if you are totally disabled and unable to work, or you are partially disabled but only able to receive wages less than what you were earning before the incident. Death benefits receive payment, based on the injury, to the survivors. Loss benefits may occur for permanent loss of use for many functions of the body such as hearing or sight, or loss of appendages, severe disfigurement or other needs. In addition, the employers are responsible to telling you that your work related illness or injury receives coverage in terms of medical costs.

Hiring a Pennsylvania Workers Compensation Lawyer

In most situations, an attorney is not necessary for filing workers compensation claims. Yet, if your claim is in denial, or the benefits are not acceptable, it may be best to work with a worker’s compensation lawyer to obtain legal advice on how to proceed with your case.

Pennsylvania Workers Compensation Office Locations

Harrisburg Office Location:
1171 S. Cameron St.
Room 324
Harrisburg, Pennsylvania 17104-2501

Most claims and information is available online or by calling Information Services at 800-482-2383