Navigating Pennsylvania’s workers’ compensation process

People in Harrisburg can find themselves injured or ill due to various situations relating to their places of employment. On-the-job accidents or illnesses that develop from exposure to harmful substances or other working environments can cause injuries that require medical treatment, disabilities and even death. When any of these situations arise, it is important for employees to know they have the right to file workers' compensation claims.

Four types of workers' compensation benefits available

The Pennsylvania Department of Labor and Industry outlines the four primary forms of benefits that are available to injured or ill workers through the workers' compensation program.

These include payments for:

  • Medical care, treatment, equipment and prescriptions.
  • Compensation of lost wages.
  • Loss of use of certain body parts or select disfigurement.
  • Death of a loved one.

Lost wages can be paid in certain instances. These include situations resulting in permanent disability or the inability to work. When workers are partially disabled but still able to work, they can only receive lost wages benefits if the amount they can earn is less than what they were earning before becoming disabled.

Seeking medical care

All employees have the right to medical care for injuries or illnesses related to job situations. For a claim paid through the state program, an employee can select any provider of choice.

However, if a workers' compensation claim is approved directly through an employer and that employer has a posted preferred list of medical providers, the employee must utilize providers from that list for the first 90 days of care and treatment. If the employer-referred provider recommends invasive treatment, an employee can seek a second opinion from another provider before proceeding.

Claim approvals, denials and appeals

Not every claim for workers' compensation is guaranteed of being approved. The reasons for denials can vary greatly. Sometimes, inadequate amounts of information were provided or forms not properly filled out. Regardless of the reason for denial, claims can be appealed first to the Workers' Compensation Appeals Board and then to the Commonwealth Court if needed or desired. A workers' compensation appeal may help employees to get approved after a denial.

Help with claims and appeals

Persons in need of workers' compensation should consider working with an attorney to increase the chances of claim approvals. Additionally, persons who are rendered unable to work for more than a year may also be able to file for social security disability benefits. An attorney can provide guidance on this process as well.