When Do I Qualify for Workers’ Compensation Benefits?
Have you been injured at your place of employment? If so, you likely have questions about what happens next. Can you receive workers’ compensation benefits for your injury? If so, how do you go about receiving them?
Specifically, if you are a new employee, you may have wondered when exactly you qualify for coverage. You may be happy and surprised to know that your coverage starts on day one. So, if your first day at work was September 1, you are covered beginning that very same day. No matter how long you have been on the job, you are covered under Pennsylvania law.
You could be one hour into your new job and be involved in an injury accident. If so, you will still receive benefits, if your injury is eligible. You are likely for workers’ compensation benefits even if you are still in training or a probation period.
Workplace injuries are never fun, so this is good news. If you are injured at work, get started on your claim right away. Here are some things you should know about the workers’ compensation process and what you need to do to get your application approved.
What is Workers’ Compensation?
Workers’ compensation is a program found in almost every state across the nation. The only state in which it is not legally required in is Texas. It offers benefits to those injured while on the job. Benefits include compensation for medical expenses and loss of wages. Your weekly amount is equal to two-thirds of your normal pay. For example, if you earn $900 a week (before taxes), then your weekly workers’ compensation pay will be $600. Workers’ compensation is different from unemployment benefits in that you do not have to have worked a certain number of hours in order to be eligible. Even part-time workers are eligible.
There is a tradeoff, though. In exchange for receiving compensation benefits, employees are not allowed to sue their employers. However, depending on the severity of your injuries and the possibility of employer negligence, it may be more beneficial to sue your employer instead.
How to Get Workers’ Compensation
Even though all employees—from newbies to older, more seasoned employees—are covered under a workers’ compensation program and eligible for benefits, it is essential to understand the laws and deadlines that apply, so you do not unintentionally miss out on the benefits you deserve.
First, there are some critical workers’ compensation facts you should know. Almost every type of employee is covered under the Pennsylvania Workers’ Compensation Act. The key word is the employee. If you work as an independent contractor or volunteer for a company, you are not eligible.
To receive benefits, you must be able to prove that your injury occurred while you were working and arose out of your work duties. If you intentionally hurt yourself, or were engaging in horseplay, acted illegally, or were drunk or on drugs at the time the injury occurred, you will be barred from receiving benefits.
There are deadlines involved, so it is essential to proceed promptly. If you are injured in the workplace, you should inform your employer within 120 days. However, the sooner, the better. As a new employee, you may not know the process, but it is rather easy. Tell someone in authority verbally or in writing. Inform your manager, supervisor, or someone from the HR department. Once you tell someone, he or she can inform you of the next steps.
You will likely have to fill out some paperwork. Your supervisor will let you know your rights and responsibilities. Typically, you will be able to see a doctor of your choice, but some employers limit your options to six or more doctors. If this is the case, you must see a doctor on the list in order to have your claim approved so you can receive benefits. No matter which doctor you choose, you must continue treatment with that doctor for a 90-day period. After that time, you can choose a different physician.
For occupational diseases—chronic conditions such as carpal tunnel syndrome, asthma, contact dermatitis, or lead poisoning—you have up to 300 weeks (just under six years) to report the injury. The period is much extended because these types of conditions develop over time and are not attributed to a one-time event. This may seem like a long time, but these types of claims are harder to prove that they occurred in a work environment.
If your workers’ compensation claim is denied, you have three years to file a petition and appeal the decision. A workers’ compensation judge will hear your case and make a determination.
Do Not Be Afraid to File a Claim
Even though they are eligible to file a claim for workers’ compensation benefits, many new employees are afraid to do so. Why? They fear retaliation.
Finding suitable employment is a challenging task. Nobody wants to lose a good job, especially if it is one they genuinely enjoy. Employees do not want to jeopardize their position. They do not want to get a demotion, pay reduction, or lose their job altogether simply by filing a workers’ compensation claim. They do not want to be harassed or belittled by their boss for filing a complaint.
This type of retaliative behavior is not only inappropriate but also illegal. No worker should face retaliation for exercising his or her legal rights. If you were a good worker who suddenly got fired merely for filing a workers’ compensation claim, you should seek legal help. You are allowed to file a claim at any time, even if your probation period has not ended. However, if your doctor claims that you are physically able to return to work, but you cannot perform your previous work duties, you could potentially lose your job.
The employer may have denied your claim simply because you are a new employee. Do note that this is illegal. Your employer must have a valid reason to deny your claim. You are entitled to benefits as soon as you start employment, so do not let your employer use scare tactics on you or lie to you and tell you that you are not covered.
If your claim has been denied, you have the right to file an appeal. A workers’ compensation lawyer can examine the facts of your case and uncover evidence that proves that your claim is valid. Do keep in mind that workers’ compensation cases are complex. As such, you should not represent yourself. You should consider hiring a lawyer if at all possible.
Get Help from a Philadelphia Workers’ Compensation Lawyer
If you are a new employee, it is important to understand your rights and responsibilities following a workplace accident. Your employer may try to deny your rights to workers’ compensation benefits. As a new employee, you may not know the process. You may also feel scared to report an injury for fear of retaliation. However, you should not be afraid to exercise your legal rights, no matter how new you are to the company’s payroll.
If your workers’ compensation claim has been denied or your employer is punishing you for filing a claim, the team of Philadelphia workers’ compensation lawyers at Krasno Krasno & Onwudinjo can help you. We have been serving Philadelphia since 1936. Contact us today at (800) 952-9640 or online to find out how we can help. A free consultation will help ensure that you understand your legal rights.
Disclaimer: This content is considered advertising and does not constitute any client-attorney privilege and does not offer any advice or opinion on any legal matter. This release was drafted by Results Driven Marketing, LLC a digital marketing, Public Relations, Advertising and content marketing firm located in Philadelphia, PA.