If you’re thinking, “I won my PA workers’ compensation case. Now what?” you’re not alone. Many people have similar questions after discovering that they won their claim. What happens after you win your case depends on the agreement between you and your employer. For example, if you settled the case and agreed to a lump sum payment, you may receive a single check shortly thereafter. But if you requested periodic payments, your benefits may come in weekly or biweekly. Furthermore, depending on the agreement, the insurance company would continue to pay your covered medical expenses for the duration of your injury.
Krasno, Krasno & Onwudinjo has championed the rights of injured workers since the 1930s. We understand the challenges faced by those hurt on the job and are committed to helping them get the benefits they’re owed under the law. Our team of Pennsylvania workers’ compensation lawyers includes a retired Workers’ Compensation Judge who participates in the settlement review process to ensure our clients receive a fair deal.
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What Are the Different Ways to Win a Workers’ Compensation Case?
When someone wins their workers’ comp claim, it can mean several different things. And how someone wins their case may impact what happens afterward. For example, the insurance company may accept their initial claim. Or, the worker may negotiate a settlement (Compromise and Release) with their employer and the insurer. The settlement may cover all or just part of the claim. If the worker lost their initial case, they may file an appeal and, hopefully, get a favorable outcome from a judge. Another way to win is to successfully file a Claim Petition to get benefits or modify their compensation package. How someone wins the case can affect what happens in the next part of the process.
I Won My PA Workers’ Compensation Case. Now What?
If you won your Pennsylvania workers’ compensation case, you may wonder what happens next. You should start receiving your benefits shortly after the settlement, claim acceptance, or court order takes effect. What you get (and when) depends on the specific terms of the agreement. If you get better and return to work, you may (but don’t always) lose your right to benefits. If the insurance company or your employer doesn’t follow through on their agreement, you can take legal action against them.
When Do I Receive My Benefits?
You should receive your workers’ comp benefits within a reasonable amount of time after winning your case. Under Pennsylvania law, your employer must pay you compensation within 21 days after receiving notice of your injury. If this does not happen, the employer is responsible for paying interest on any amounts they owe you.
If your case is at the litigation stage, receiving benefits may be a bit different. The workers’ compensation judge (or panel) assigned to your case can determine the appropriate payment amount and schedule. So, you may receive temporary benefits while the case is ongoing. When you win your case, payments may arrive shortly after that based on the new (or existing) schedule.
How Much Will I Receive in Workers’ Compensation?
The total amount of your compensation package depends on your unique situation. Each workers’ comp settlement is different, based on factors such as the severity and type of your injury and your impairment rating. What’s more, the terms of the final agreement (whether it’s a settlement or court order) dictate how much you receive.
For example, if you have a total disability, you may receive 66 and two-thirds of your pre-injury weekly wages. If you choose to get this in weekly or biweekly payments, this may continue for 104 weeks. At that time, a doctor would reevaluate you to determine your new impairment rating. If you still qualify for total disability, you may continue getting checks as before. But if you choose to receive a lump-sum settlement, you may get a fixed amount, regardless of whether your situation worsens.
If you litigate your workers’ compensation case, the judge (or panel) has the final say in the outcome. They can decide if, how much, and when you receive benefits. In that case, the amount you get depends on the terms of the judge’s order.
Do I Still Get Compensation if I Get Better?
If you receive total disability benefits and your condition improves, you may qualify for partial disability benefits instead. The amount you receive may (or may not) change, but the length of time the payments continue may change.
Additionally, the decision to return to work can impact how much compensation you get. In some situations, going back to your old job (or any position) may cause you to lose your benefits entirely. But it depends on the circumstances. For example, if you received a lump-sum settlement, it’s unlikely that going to work again will impact your benefits. But if you’re receiving periodic payments, earning money through employment may make you ineligible for some or all of your current benefits.
What Happens if the Insurance Company Doesn’t Do What They Agreed To Do?
If your employer or their insurance company doesn’t follow through on what they are supposed to do, you can take legal action to enforce the court order or settlement. What you need to do to accomplish this depends on the unique situation. For example, this might involve filing a claim petition with the Pennsylvania Bureau of Workers’ Compensation.
What Do You Receive If You Win Your Workers’ Comp Case?
If you win your case, you might receive the following in compensation:
- Interest on unpaid benefits,
- Money to cover your past and future expenses,
- Wage replacement benefits, and
- Specific loss benefits.
You might receive this in one lump sum, periodic payments, or a mixture of both. Before you accept a compensation offer, it’s a good idea to talk to an experienced attorney. They have the tools to review the agreement and determine if it’s in your best interest. Workers’ compensation lawyers can also negotiate a fair deal or help you appeal your case if the insurance company doesn’t cooperate.
Interest on Unpaid Benefits
If your employer owes you back pay or medical expenses, you may receive what you’re owed plus interest. In many cases, the annual interest rate is 10 percent and runs until your employer is up-to-date on payments.
Past and Future Medical Expenses
Workers’ compensation covers your past and future medical bills as long as they are reasonably related to your job injury. If you win your case, you (or your provider) submit medical claims to the appropriate insurance company. In many cases, the insurer should pay these when they receive them, even if they are still pending. But it depends on the specific situation and whether you had the appropriate prior authorization to see that doctor.
Wage Replacement Benefits
You may be entitled to receive money to cover your lost earnings while you are hurt or recovering from your injury. The amount of these benefits varies from case to case. For example, you may be eligible for up to 500 weeks of partial disability payments. Under this structure, you may receive a percentage of the difference between your current earning potential and what you made before the incident. But this amount can’t be more than the statewide weekly average. If it is, you might get the lesser of 50 percent of the statewide average or 90 percent of your wages.
Specific Loss Benefits
If you experience a particular type of injury (like a leg amputation), you may receive a set amount. Pennsylvania law outlines these specific loss benefits. For example, losing a lower leg may entitle you to receive 66 and two-thirds of your wages, which you may receive for 350 weeks.
How Often Do You Receive Workers’ Compensation Payments?
How often you get your workers’ comp benefits depends on the arrangement between you, your employer, and their insurance company. For example, if you choose to receive periodic wage replacement payments, you may get a check weekly or biweekly. You would also receive payments for your medical bills periodically (e.g., as the claims come in). But if you agree to a lump-sum settlement, you might get a single check for a specific amount, which might cover your wage loss and medical expenses.
What Happens if You Win Your Workers’ Comp Case, But Your Condition Gets Worse?
If your situation worsens after you win your case, you may be able to request additional funds. This might happen if you received partial disability and now qualify for total disability benefits. Or it may come up if your condition lasts much longer than expected or you get re-injured after returning to work. In any of these situations, you or your employer may submit a notice to modify your compensation. If you disagree with the amount of compensation you receive, you may challenge this decision by filing a claim petition.
Krasno, Krasno & Onwudinjo Can Help You Win Your Workers’ Comp Case
Going through the workers’ compensation process is not easy, but it’s the most effective way to get what you need after a work injury. If you win your case, you should receive benefits based on the arrangement between you, your employer, and their insurance company. If you need additional compensation because your condition worsens, you may be able to request this. Likewise, if your employer isn’t following the terms of the agreement or court order, taking further legal action may be necessary.
Andrew Onwudinjo has been fighting for injured workers since 1989. He understands the difficulties faced by those who suffer workplace injuries. Andrew helps to restore his clients’ dignity while pursuing every cent they deserve under Pennsylvania laws. His impressive career spans over three decades and includes successfully arguing workers’ compensation claims in front of the Pennsylvania Supreme Court.
If you were hurt on the job and want to know what happens after you win your workers’ comp case, contact us today by calling 844-948-2338 to schedule a free consultation.