Handbook for Workers’ Compensation Eligibility in Pennsylvania 

September 16, 2024 | Workers’ Compensation

Handbook for Workers’ Compensation Eligibility in Pennsylvania

Have you been injured on the job in Pennsylvania? If so, you may be eligible for workers’ compensation benefits. Understanding Pennsylvania workers’ compensation laws helps workers know what to expect as they go through the workers’ compensation process. 

What Are the Eligibility Requirements for Workers’ Compensation in Pennsylvania?

Generally, an injured worker qualifies for workers’ compensation benefits if the following criteria are met:

  • You were employed by an organization that is required to have workers’ compensation insurance for their employees.
  • You were injured or developed an occupational disease while you performed duties in the ordinary course of your employment.
  • You did not intentionally cause your injuries.
  • Your injuries were not the result of willful misconduct.
  • You were not intoxicated or impaired by drugs at the time of your workplace accident.

The injury does not need to occur on the employer’s premises to be covered by workers’ compensation. A worker can be in another location and receive benefits if they were acting within the scope of their employment. For example, you are not covered while traveling to and from a job site, but an accident on a job site would be covered if you were performing your ordinary work duties.

Are There Exceptions to Pennsylvania Workers’ Compensation Requirements?

Most employees in Pennsylvania are covered by workers’ compensation. The Pennsylvania Workers’ Compensation Act requires most employers to have workers’ compensation insurance, including businesses, non-profit corporations, and employers with at least one employee. However, some employers are exempted from workers’ compensation. Workers who may not be covered by Pennsylvania’s workers’ compensation system include:

  • Railroad workers
  • Domestic employees
  • Longshoremen, harbor workers, and shipyard workers
  • Federal employees
  • Agricultural workers who work less than 30 days or earn less than $1,200 in a calendar year from one employer
  • Employees who have requested and been granted an exemption because of the executive status with specific corporations or due to religious beliefs
  • Volunteer workers
  • Independent contractors, consultants, and freelancers

Some of the above workers may be covered by another workers’ compensation system. If you are unsure whether workers’ compensation covers you, reach out to a Lancaster workers’ compensation lawyer for a free case review.

What Types of Injuries and Illnesses are Covered by Workers’ Compensation in Pennsylvania?

The following conditions are eligible for workers’ compensation benefits under Pennsylvania law:

  • Repetitive activity that results in an injury
  • Specific incidents that cause an employee to be injured
  • A pre-existing condition that is aggravated by work activities

The Workers’ Compensation Act lists specific occupational diseases covered by workers’ compensation. Additionally, other occupational diseases are covered if they meet three criteria:

  • The worker was exposed to the disease because of their employment
  • The disease is related to the worker’s occupation or industry AND
  • The disease occurs more in the occupation or industry than in the general population

As with pre-existing conditions, you may be eligible for workers’ compensation benefits if you have a pre-existing occupational disease aggravated by your employment. It is important to seek legal advice if your employer or the workers’ compensation insurance company denies your claim. 

An attorney can help you file an appeal arguing the injury or disease is covered by workers’ compensation, but there is a deadline for filing workers’ compensation appeals.

Can a Worker Receive Workers’ Compensation if They Are at Fault for Their Injuries?

Workers’ compensation is a no-fault system. Therefore, even though workers are to blame for their injury, they can still receive benefits if their injury or illness meets the eligibility criteria.

However, there are some exceptions. Workers’ compensation does not cover intentional injuries or injuries that occur when you are intoxicated. Likewise, workers’ compensation does not cover injuries that occur because of horseplay or fighting at work.

What Benefits Does an Injured Worker Receive for Pennsylvania Workers’ Compensation?

An injured worker can receive several types of benefits, including:

  • Medical treatment
  • Loss of income benefits if they are partially or totally disabled
  • Death benefits for family members
  • Specific loss of benefits

Workers’ compensation does not compensate workers for pain and suffering damages. If a third party caused the work-related injury, a worker may pursue a third-party claim for additional damages.

If you still have questions about workers’ compensation in Pennsylvania, contact a Lancaster workers’ compensation attorney today.

If you’ve been injured in a workers’ compensation, please contact Marzzacco Niven & Associates at the nearest location to schedule a free consultation today:

Harrisburg Law Office
945 East Park Drive, Suite 103 Harrisburg, PA 17111
(717) 231-1640

York Law Office
2550 Kingston Road, Suite 210A York, PA 17401
(717) 995-8998

Wyomissing Law Office
833 N. Park Road, Suite 103, Room A Wyomissing, PA 19610
(717) 388-2325

Chambersburg Law Office
79 St. Paul Drive, Suite 1 Chambersburg, PA 17201
(717) 388-2378

Carlisle Law Office
354 Alexander Springs Road Carlisle, PA 17015
(717) 995-8732

Carbondale Law Office
30 Lincoln Avenue, Suite 101 Carbondale, PA 18407
(717) 995-8810

Lancaster Law Office
2173 Embassy Drive, Ste 123, Lancaster Pa 17603
(717) 616-2954

Lebanon Law Office
937 Willow Street, Suite D Lebanon, PA 17042-1140
(717) 995-8963