Workers Comp

Workers’ Compensation Attorneys in York, PA

Legal advocacy for injured workers and employees in South Central Pennsylvania

Workers’ compensation covers injuries and health conditions that occur as a result of employment. An injury that qualifies for workers’ compensation must be the result of a verifiable event that happened within the scope of the injured person’s employment, or while performing work-related duties. For example, an employee might suffer injury from a warehouse accident on the job, or may slip on ice in the company parking lot. Either of these would qualify.

Even in safe workplaces, accidents can happen, and you or a family member may get injured on the job. If you work in a hazardous environment, you are also at risk of developing a disease or illness caused by your occupation. If you become injured or ill while on the job or performing your work duties, you may be eligible for workers’ compensation benefits. It is important to know your rights and understand how to file a claim so you can properly secure your benefits. Talk to the York, PA workers’ compensation attorneys at KBG Injury Law today for help with your claim, or assistance if your claim is denied.

What is workers’ compensation in Pennsylvania?

Here in Pennsylvania, the Pennsylvania Workers’ Compensation Act defines state workers’ compensation laws. Under the Act, you are entitled to compensation if you suffer a work-related injury or illness. This covers your medical expenses related to the illness or injury, as well as wage loss compensation for as long as your injury or illness prevents you from returning to work.

The Act also dictates the terms by which employers and their insurers are responsible for death benefits for those who suffer work-related fatalities. In these cases, compensation is paid to the worker’s surviving dependents.

To ensure all employees will be covered in the event of a work injury, all employers are required to carry workers’ compensation insurance — either from a private insurer or the State Workers’ Insurance Fund — to pay for these benefits. Additionally, the law in Pennsylvania dictates an employee’s workers’ compensation benefits are not contingent upon who is at fault for the injury. That means if you suffered injury because of your own mistake, you are still entitled to benefits.

Because of these no-fault rules, those who collect workers’ compensation benefits may not seek legal action as a means of procuring additional benefits, such as suing their employer. It is imperative for injured workers to contact an experienced law firm like KBG Injury Law so you receive all the benefits to which you are entitled. Additionally, if the injury is one of the rare conditions that warrants additional legal action, an experienced attorney is best-suited for exploring this option.

Here in Pennsylvania, the state calculates your workers’ compensation benefits using your weekly wages. Generally, you will receive about two-thirds of your weekly wages, up the maximum amount. This amount changes yearly, with 2021’s maximum at $,1,130.00.

Do I qualify for workers’ comp in Pennsylvania?

According to the Pennsylvania Workers’ Compensation Act, nearly all workers in Pennsylvania are covered by workers’ compensation. By law, employers must provide workers’ compensation insurance coverage for their employees, including seasonal and part-time workers. Unincorporated business, non-profits and even employers with only one additional employee are required to provide this coverage.

There are some special exemptions, typically because workers have some other form of coverage. These include longshoremen, railroad workers, harbor and shipyard workers, federal civilian employees, certain agricultural workers, casual employees, certain domestic workers, and employees with a specific religious exemption. Additionally, independent contractors are, by definition, not employees so they are not covered by the Workers’ Compensation Act, and some executives within corporations may opt out of workers’ compensation coverage.

If you are unsure if you are covered under workers’ compensation, it is best to seek a legal opinion from an experienced attorney.

What is covered under workers’ compensation?

As mentioned earlier, workers’ compensation takes on a few forms. Workers’ compensation benefits can include:

  • Payments for lost wages. One of the most important and commonly claimed workers’ compensation benefits covers wage loss. For those who cannot work at all while they recover from an injury or illness, these wage loss benefits will allow the worker to continue paying the bills and providing for their family. Even those who can only work part-time or in a limited capacity after suffering an injury are entitled to workers’ compensation benefits.
  • Death benefits. Death benefits can be provided to the surviving spouse as long as they lived with the employee at the time the death occurred. If they were not living with the employee at the time of death, but were still legally married, they must also prove that they were financially dependent on the employee. Dependents under the age of 18 can also receive benefits, and full-time students may continue receiving benefits until age twenty-three. If there is no surviving spouse or dependent children, death benefits may be paid to the parent or siblings of the employee of they can prove that they were financially dependent on the employee at the time of death. Death benefits also include a one-time lump sum funeral benefit.
  • Specific loss benefits. There are some cases where a work-related injury may result in the loss of, or the complete loss of use of a body part. For example, an accident may result in the traumatic or surgical amputation of a finger or appendage, or damage so severe to that finger or appendage that its use is lost for all practical intents and purposes. In these cases, there are specific loss benefits designed to compensate the permanent loss of that function. Specific loss benefits also cover the loss of hearing and vision and disfigurement of the head face or neck resulting from a work injury.
  • Medical care. Even if a work-related injury or illness did not result in time off work, you are still entitled to benefits if you have incurred any medical bills related to your care. Covered medical expenses include supplies, medicine, emergency room or doctor’s office visits, surgery, orthopedics and prostheses. Many medical bills will be covered under either the employee or employer’s insurance, but the employer must cover any out-of-pocket costs.

However, be aware that if you seek medical care outside of Pennsylvania, some expenses may not be covered. Consulting with an experienced attorney will ensure you do not accidentally seek treatment that is not covered.

Also, if your employer has posted a list of six or more approved medical providers in the case of injury, your initial visits for medical treatment must come from this list, as well as any subsequent visits for the next 90 days.

You may be required to undergo an Independent Medical Examination (IME) or an Impairment Rating Evaluation (IRE). During an IME, a physician will evaluate your current condition, its causal connection to your work injury and your current work capabilities. During an IRE, a physician will calculate the percentage of your impairment to determine whether a worker should be on partial or total disability benefits. If you get scheduled for an IME or an IRE you should contact one of the workers’ compensation attorneys at KBG Injury Law to discuss your options immediately.

Your insurance company may also have a nurse contact you or accompany you to your doctor’s appointment. These Nurse Case Managers (NCMs) work for (and are paid by) the insurance company, and it is important to remember that you do not have to allow an insurance company nurse to come to your appointment, and you are not required to provide an NCM with your medical information. Talk to the attorneys at KBG Injury Law if you have any questions about this.

What injuries and occupational diseases are covered under workers’ comp?

According to the Pennsylvania Department of Labor & Industry, nearly any injury or condition resulting from your job can make you eligible for workers’ compensation. This can include:

  • A specific incident or accident, like a slip and fall or machinery accident.
  • A series of actions leading to a repetitive stress injury, like carpal tunnel syndrome.
  • A pre-existing condition worsened by your job, like asthma.
  • Occupational illnesses for certain workers, like tuberculosis or hepatitis for medical professionals, or diseases of the heart and lung for firefighters.

What should I do after a work accident or injury?

You should always inform your employer of your injury as soon as possible. Delays in reporting an injury can result in delays in coverage. The statute of limitations for workers' compensation requires that a Claim Petition be filed with the Bureau of Workers' Compensation within three years of the date of injury.

Remember, employers and their insurers are incentivized to find ways not to pay you your benefits. While Pennsylvania has enacted laws to make sure your rights are protected, insurers pay lawyers to find loopholes and other means under the law to deny payment. Delays in reporting only make denying payment easier.

By law, employers are required to report injuries and missed work to the Bureau of Workers’ Compensation using what is called a “first report of injury.” If you have reported your injury, informed your employer of medical expenses and they fail to cover it, it can serve as crucial evidence in your employer’s failure to comply with their legal obligation. However, if you do not make your injury clear to your employer, they can use this as a defense.

Why is my employer suggesting disability instead of workers’ comp?

Employers who are looking to avoid paying out workers’ compensation benefits might advise an injured employee to opt for short-time disability or unemployment benefits rather than workers’ compensation. Know that these disability and unemployment benefits are better for the employer, not for you as the employee. There are many reasons workers’ compensation is superior to disability benefits, so be wary of an employer making such a suggestion.

Some of the benefits of workers’ compensation coverage include:

  • Not having to pay taxes on your benefits.
  • Receiving more benefits financially and overall.
  • A longer window of availability compared to state benefits or unemployment benefits.
  • The availability of partial benefits even after returning to work.
  • Coverage of all appropriate medical expenses, regardless of amount and without deductibles.

If your employer is attempting to convince you to take short-term disability over workers’ compensation, they do not have your best interests at heart, and you will need help getting the full range of benefits you deserve. Do not hesitate to seek legal representation in such cases.

When do Pennsylvania workers’ compensation benefits end?

There are several different reasons why your workers’ compensation benefits may end through a suspension (your wage loss benefits stop but you medical benefits continue) or a termination (both your wage loss and medical benefits stop). If your workers’ compensation benefits are suspended or terminated, there may be a few reasons why.

  • Failure to comply with a doctor’s orders or prescribed medical treatment.
  • Refusal to undergo an independent medical exam (IME) or complete a vocational interview.
  • Conviction of a crime that sends you to jail.
  • Failure to complete the Employee Verification Form within 30 days.
  • A judge reviews and suspends or terminates your claim.
  • You sign a Supplemental Agreement or “Final Receipt” agreeing to end your benefits.
  • Your partial disability 500-week period has ended.
  • You returned to work and are earning the same or more than before your injury.
  • You have accepted a lump-sum settlement for your workers’ comp case.

Remember, never sign anything without having an attorney review it first, especially in cases of lump-sum settlements or agreements to end your benefits. Our York, PA workers’ compensation lawyers can help ensure you secure the proper compensation to which you are entitled, for as long as you are entitled to them.

What happens if I am laid off while I’m injured?

Depending on your employer, your specialization within your job, and whether you belong to a union, you may find your employer fills your position while you are recovering from your injury. If you do not have a contract that specifies otherwise, this is their legal right. However, your employer cannot fire you or retaliate against you for filing a workers’ compensation claim.

Your workers’ compensation benefits are not contingent on your employment. If your injury is preventing you from working, you are entitled to lost wage benefits. Additionally, medical expenses will still be covered by workers’ compensation insurance. If you feel your employer laid you off in order to deny you your rightful workers’ compensation benefits, seek out legal counsel immediately. The attorneys at KBG Injury Law can help.

Is there a workers’ compensation attorney near me?

You can find KBG Injury Law at 110 North George Street, in the heart of York, PA. Our offices are near Interstate 83 and Routes 30, 74 and 462.

Helpful and experienced York, PA workers’ comp lawyers

Here at KBG Injury Law, we take your injury as personally as you do. We understand a work-related injury is more than just a financial burden. You deserve to have someone on your side to listen to you and your needs — not just someone who will look at you as just another transaction. If you have been injured on the job and have questions or feel you are not getting the workers’ compensation benefits you are entitled to, contact our attorneys for a free consultation. Call 717-848-3838 or toll free at 800.509.1011 or fill out our contact form to schedule a consultation. We have offices in York, Lancaster, Harrisburg, Hanover, and Gettysburg, and help individuals and families throughout South Central Pennsylvania.