What to Do After Winning Your Workers’ Comp Case In PA

Workplace injuries can occur in any work environment, and they can result in medical expenses, lost wages and even disability. Employers in Pennsylvania are required to have workers’ compensation insurance. These benefits cover an employee’s costs related to the workplace injury, and they are typically paid by an insurance company. However, the insurance company or the employer may dispute the claim. After a Workers’ Compensation Judge issues a Decision on your case, either party in Pennsylvania can file an appeal with the Workers Compensation Appeal Board. Now that you have won your appeal, what can you expect?

Receive Workers Compensation Benefits for Accrued Expenses and Losses

After winning your workers’ comp case, you need to know when you will receive benefits. Medical expenses may be mounting, and you may be falling behind on your other bills because of your inability to work. The insurance company will pay all outstanding medical bills within a few weeks after the appeals process has been finalized. Keep in mind that the insurer is also responsible for future medical expenses related to the workplace injury. You also may receive compensation for to-date lost wages within 28 20 days of the appeal ruling.

Expect Future Workers Compensation Benefits

In many cases, the injured party will require ongoing medical attention after the appeal ruling. Likewise, the inability to work and earn a living may continue. The insurance company is required to continue paying out on claims for related expenses and lost wages, potentially indefinitely. In fact, your claim could remain open throughout your lifetime. Generally, medical bills will be paid in a timely manner once the insurance company receives them. You may also receive regular payments to supplement your lost wages. However, the insurance company may offer you a lump sum payment upfront. If you accept this agreement, no additional compensation will be provided. The insurance claim will be closed.

Consider Agreeing to a Settlement

In Worker’s Compensation, a settlement is known as a “Compromise and Release”.

There are many different ways to settle the case. Some settlements end the case completely. Other settlements can be for a part of the case and the remaining parts continue to be open.

Settlements can occur before litigation, during litigation, or even during the appeal process. All settlements must be approved by a Workers’ Compensation Judge at a hearing (either live or virtual).

In most cases, settlements result in a payment of lump-sum benefits to compensate the injured worker for past and/or future medical benefits and wage benefits.

In a “fulll” settlement, your case will be “closed “, and the insurance company will have no further obligation to pay anything on your case.

Settlements can be as simple or as complicated as required by your case. You must have a skilled lawyer to navigate all the complexities of a settlement because they may affect other rights such as a pension, long-term disability, future medical care etc.

Never try to negotiate a settlement yourself because you have so much at stake.

Seek Legal Representation Today

Regardless of where you are with the workers’ compensation process, it is important that you have professional legal representation. The legal team at Krasno, Krasno & Onwudinjo has extensive experience with all aspects of workers’ compensation cases in Pennsylvania. To discuss your case with one of our lawyers, contact our firm today here.

Frequently Asked Questions After Winning a Workers’ Compensation Case

 

When can you expect to receive your workers’ comp payments?

In Pennsylvania, you may receive workers’ compensation benefits for lost wages after you have been off the job for seven days. However, there is a retroactive compensation period of 14 days. Keep in mind that you must report the injury to your employer within 21 days in order to qualify for retroactive compensation. For medical expenses, the insurer or the employer may pay the bills after the claim is filed, even if it has not yet been approved.

How frequently do your workers’ comp benefit payments arrive?

Workers’ compensation benefits for medical bills are generally paid by the insurance company as the bills arrive. Income benefits are paid according to the employer’s normal pay schedule. For example, if you receive a paycheck every week, you will receive a workers’ compensation check every week to replace your lost wages. The insurer is required to pay interest on late payments. If late payments are excessive, the insurer may be charged a monetary penalty.

How long do workers’ compensation benefit payments continue?

There are three different kinds of benefits payable in a Worker’s Compensation case.

  • Wage loss benefits
  • Medical benefits
  • “Specific loss” benefits

You would be entitled to receive total disability wage loss benefits if you are unable to work or your employer cannot accommodate the medical restrictions you have. In addition, you would be entitled to temporary partial disability benefits if you are working but earning less than your pre-injury “average weekly wage”. There are other circumstances where you may be entitled to receive partial disability benefits, but they are too complicated to go into without discussing them with your attorney.

Specific loss benefits are paid when a body part has been amputated, or there is a functional loss of use. There can also be specific loss benefits for vision and hearing under certain circumstances.

Medical benefits can continue perhaps indefinitely as long as they are reasonable, necessary and related to your injury.

Wage loss benefits can potentially be indefinitely, but the insurance company has tools to “shut the window” on how long they pay you total disability benefits.

Partial disability benefits are usually capped at 500 weeks, with some exceptions.

If you have questions about how long your benefits may continue, please contact us here.

Can you be forced back to work after an injury?

Depending on the nature of your injury, your employer may offer you a position that is aligned with your current physical abilities. If so, the employer will file a “Notice of Ability to Return to Work.” This statement will include a statement from the doctor that details physical work restrictions related to the injury. If this position pays less than your previous position, you may receive partial workers’ comp benefits for the income differential.

 

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