Can I Sue My Employer for Not Reporting My Injury or Filing a Workers’ Compensation Claim?
After suffering a serious workplace injury, the last thing you want to hear is that your employer refuses to file a workers’ compensation claim on your behalf. If you are in this situation, you may wonder, Can I sue my employer for not reporting my injury? In most cases, you cannot sue your employer if you suffer a work injury. Instead, the only way to recover financial support is to file a claim within the Pennsylvania workers’ compensation system. If your employer refuses to report the injury, you may contact the Bureau of Workers’ Compensation. In some cases, you may be able to take legal action, such as by filing a Petition for Penalties, if your employer or their insurance company does not follow the law. It is important to act swiftly to make sure that you file the proper paperwork within the required timeframe.
Since the 1930s, Krasno Krasno & Onwudinjo has helped injured workers fight back against the unfair practices of employers looking to cut corners to save money or time. We have a deep understanding of Pennsylvania workers’ compensation laws and the tactics employers and their insurance companies use to avoid paying out due compensation to workers. Our Pennsylvania workers’ compensation lawyers are prepared to fight for you so you can support yourself and your family while you heal and get back on your feet.
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What Can I Do If My Employer Refuses to File a Workers’ Compensation Claim for My Injury?
Within 48 hours after receiving notice of an injury resulting in death, the employer must report the incident to the Bureau of Workers’ Compensation. If an injury resulted in a missed shift, turn, or day at work, your employer has seven days to report it to the Bureau.
It can be incredibly frustrating if your employer refuses to file a workers’ compensation claim. After all, you may count on the benefits to support yourself and get the medical help you need to get better. If your employer does not report the injury, you have a couple of options. You can notify the Bureau of Workers’ Compensation to ask that they take action to encourage your employer to file a First Report of Injury (FROI) to open the claim. If you know your employer’s workers’ compensation insurance carrier, you or your attorney may contact the insurance company and inform them of the injury. In some cases, you may be able to file a Petition for Penalties.
It may be beneficial to contact an attorney to have them help you with this process. Your employer must notify their insurance carrier immediately after they receive word that an employee suffered an injury. If this does not occur, you must act quickly to make sure deadlines do not pass without your knowledge. Further, it is important for you to get the medical help you need to prevent your condition from getting worse. Acting without delay helps to enable this to occur.
Can I Sue My Employer for Not Reporting My Injury?
In most cases, the Pennsylvania Workers’ Compensation Act prevents employees from suing their employer if the worker suffers an injury while working. That said, you may be able to take legal action if your employer violates Pennsylvania law. One such action is filing a Petition for Penalty to require your employer to take action and reimburse you for your medical expenses incurred because of their delay. You can also contact the Bureau of Workers’ Compensation to try to initiate the claims process or ask that they take action, such as sending a notice to your employer. Further, you may be able to initiate the report by contacting the insurance company directly.
An attorney can help you understand your rights and prepare an appropriate response in this situation. Since your employer may not be doing what they should be doing under the circumstances, it may fall on you to do so. But an attorney can help you navigate the situation without opening yourself up to liability or inadvertently jeopardizing your claim.
Further, if your employer does not have workers’ compensation or has insufficient workers’ compensation coverage, you may be able to file a claim with the Pennsylvania Uninsured Employer’s Guaranty Fund. This fund is in place to help ensure injured workers get the compensation they deserve if their employer does not carry an insurance policy as required under the law. A lawyer can help you determine if this is a viable option in your case.
What Should Happen After a Worker Suffers an Injury While on the Job?
Once a worker suffers an on-the-job injury or discovers that their condition is work-related, there are a couple of steps to follow. The employee should notify their employer about their injury and seek medical attention. The worker should follow up to ensure their employer filed the appropriate paperwork. Finally, if the insurance company denies the workers’ comp claim, the worker can file a lawsuit to have a workers’ compensation judge hear the case.
1. The Employee Notifies Their Employer About the Injury
In most cases, the Pennsylvania Workers’ Compensation Act requires claimants to report work-related injuries to their employers within 21 days after the injury. The date of the injury typically runs from when the employee discovers the injury or realizes it is work-related.
Claimants (injured workers) may still report the injury up to 120 days after discovering it. But the benefits they receive may be back-dated to the date of the notice rather than the date of the injury if they report it outside the initial 21-day period. Failure to report an injury to your employer within the 120-day period may disqualify the worker from receiving workers’ compensation benefits. But this deadline may not apply to workers who have work-related progressive diseases. An attorney can help you understand your right to compensation in your specific situation and help you meet the applicable reporting deadlines.
Employees who suffer work-related injuries or illnesses should inform their employer of their injury as soon as possible. Doing so can increase the strength of their case, improve the likelihood they will receive potential benefits, and help to limit the potential disputes about the claim. The insurance company may point to reporting delays to argue against accepting the claim. Claimants can combat this by acting swiftly. Further, doing so also puts the employer on notice to notify its insurance company and file the First Report of Injury with the Bureau of Workers’ Compensation.
Employees might benefit from reporting the injury in writing and verbally to their employer. Filing the report in written form helps to create a physical record of the injury report, should eligibility questions arise during the claims process. Certain employers will have accident reports available to complete for these kinds of scenarios. When making a written report to your employer, be sure to make a note of the time and date of injury, the location of the accident or workplace activity resulting in injury, and any symptoms stemming from the injury.
2. The Employee Seeks Immediate Medical Attention and Treatment
After you report your injury, your employer must report it to their insurance company and file the First Report of Injury with the Bureau of Workers’ Compensation. Following a report of injury, your employer is legally obligated to file a report with their workers’ compensation insurance provider. If your employer posts a list of at least six healthcare providers and accepts your claim, you usually must see one of the providers on the list. In other situations, you may choose your own doctor.
Pennsylvania law usually only requires claimants to treat with employer-approved providers for the first 90 days of treatment. After 90 days, you may seek treatment from any medical provider you wish. When seeking medical care from a provider, you should notify your employer to keep them informed.
If your employer does not post a list of providers, you should still seek treatment (with any qualified provider) immediately following your injury and bill any expenses under your own health insurance (if applicable). If you receive workers’ compensation benefits, you may be reimbursed for qualified out-of-pocket medical expenses and outstanding bills.
While receiving treatment for work injuries, make sure to tell your doctor or healthcare providers that you acquired the injury while working. Doing so helps strengthen the written record of your workplace injury to help increase the chance the insurance company accepts your claim. You should also provide your medical provider with the name and contact information of your employer to add to your medical records.
Medical providers can diagnose and attribute specific workplace activities to injuries and illnesses, further increasing the likelihood of a successful workers’ compensation claim. Medical records can also serve as evidence against employers who refuse to file accident reports and workers’ compensation claims for injured employees.
3. Check the Status of Your Claim With the Bureau of Workers’ Compensation
Under Pennsylvania law, employers must file a First Report of Injury (FROI) with the Bureau of Workers’ Compensation within seven days of their first workplace injury-related absence. In certain extreme cases, such as work-related deaths, employers must file the FROI within 48 hours. They must also notify their insurance provider about the injury right away.
These reports are important because they function as the first step in establishing workers’ compensation claim eligibility for injured employees. Further, they initiate the claims process and open a case with the Bureau of Workers’ Compensation.
You can check the status of the workers’ compensation claim by going online or by talking to your employer. If your employer fails to file the FROI, the Bureau of Workers’ Compensation does not have a claim open in its system. You can remedy this by contacting the Bureau, your employer, or their insurance company. A lawyer for workers’ compensation can also help with this process to ensure your rights are protected.
4. The Employee Appeals the Denial of Their Claim
Within 21 days after the employee notifies the employer of the injury, the workers’ comp insurance company typically must either approve or deny the claim. In some cases, they may ask for additional information or evaluations.
If your employer denies your claim or refuses to file a First Report of Injury with the Bureau of Workers’ Compensation, you have options. Under the Pennsylvania Workers’ Compensation Act, you have the right to appeal the denial by filing a Claim Petition. Further, if their employer or their employer’s insurance company does not follow the rules outlined in the workers’ comp law, the worker can take legal action, such as by filing a Petition for Penalties.
During a workers’ comp hearing, the injured worker can present the evidence they have to support their claim and prove that they are entitled to benefits. They might accomplish this by submitting medical records, asking doctors to testify, or submitting evaluation reports. They can also present evidence showing their employer or their employer’s insurance company did not comply with the reporting requirements or the proper procedure for investigating claims. At the hearing, the workers’ comp judge also hears testimony, arguments, and evidence from your employer.
At the conclusion of the hearing, the workers’ compensation judge makes a decision in the case. The employee has the right to appeal the final decision by filing a claim with the Workers’ Compensation Appeal Board. If the appeal board also renders an unfavorable decision, the injured worker can file an appeal with the commonwealth court or, in some cases, the Pennsylvania Supreme Court. Because of the intricate court rules and procedures involved in these matters, it may be in the workers’ interest to hire an attorney to help them prepare and present their cases to the judges.
Contact an Experienced PA Workers’ Compensation Attorney for Help
Our team has no tolerance for employers who skirt the law and do not file injury reports when they should. We understand what this means to you and what is at stake. We can thoroughly investigate your case to determine what needs to happen to help set you up for success. Then, we can work with you to accomplish this goal by making phone calls, sending letters to your employer, filing the necessary paperwork, or attending a workers’ comp hearing on your behalf. We can also help you coordinate medical care.
Our team tirelessly dedicates itself to helping injured workers improve their lives and get the help they deserve under Pennsylvania law. Jason Krasno has over 23 years of experience fighting for injured workers. He takes inspiration from his grandfather, who founded the firm in the 1930s. Jason has built on the legacy laid down by his grandfather and father to grow the practice. Since its founding, Krasno Krasno & Onwudinjo has successfully helped over 300,000 injured workers.
If you were hurt on the job, contact our team today by calling 844-243-4843 or using our online contact form.