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Frequently Asked Questions (FAQs): Workers' Compensation

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Navigating legal matters can be complicated, and at Kunkle and Sennett, we expect that you will have questions. We have gathered some of our most frequently asked questions here. If you have other questions, please check the services tab for a list of the types of legal cases we take on. We also welcome you to contact us directly.

Workers' Compensation

There are many factors that insurance companies consider in evaluating the settlement value of a workers’ compensation claim. In Pennsylvania, compensation is paid based on the employee’s pre-injury earnings. Therefore, a claim that produces a high-level loss of earnings is worth much more than a claim with a low-level loss of earnings.

There is no pain and suffering component to workers’ compensation benefits, so the severity of the injury only affects settlement value in so far as it impacts the employee’s loss of earnings. The insurance company does not care what impact the injury has on the life of the affected worker.

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Obviously, there are other factors besides pre-injury earnings that affect the projected loss of earnings, including the individual’s educational and vocational background, their training, other health issues, and their age. It is also important to understand how the insurance company evaluates its reserves on a claim (money set aside to cover their exposure) in order to come up with an appropriate settlement figure. At Kunkle and Sennett, your workers’ compensation attorney in West Chester, PA, we make sure you understand the entire settlement process, so you know that we are maximizing your recovery and structuring the best deal for your particular circumstance.

We all have to cope with stress to some extent. Usually, we can handle it, but sometimes as stress builds up, we have greater and greater difficulty with it until we don’t think we can take it anymore.

One of the most significant potential generators of stress that can happen to a wage earner is to suffer a disabling work injury. Any injury can be a source of stress, but when the injury is serious enough to take you out of work, what naturally follows is worry and anxiety. When you combine the burden of healing and recovery with losing your income stream and possibly losing your job, an injured worker may feel trapped and unable to cope.

Legal Counsel for Disability Benefits in West Chester

If someone is injured enough that they are disabled, they usually don’t need a lot of encouragement to seek medical care for their physical injury. However, many of my clients, burdened with the stress and anxiety of healing, losing money, and worrying about their job, are still reluctant to seek any medical help for the mental side of their injury. Many people feel that there is still a negative stigma attached to any type of psychological or psychiatric counseling, despite the legitimate high anxiety that comes from being physically injured and unable to work.

Obviously, each individual is different and will be affected differently, but don’t be afraid to talk to your doctor about worry and anxiety when you see them for your injury. Seek help when you need it.

If you are injured at work, the first thing to do is notify your employer of your injury. To be entitled to workers’ compensation benefits, the employee must meet all the elements required by the Workers’ Compensation Act and one of those elements is notice. Failing to notify your employer of your injury in a timely manner can completely bar your claim.

The employer must have “knowledge of the occurrence of the injury,” or the employee must “give notice thereof” within 21 days of the injury; if not, then no compensation is due until notice is given, and unless notice is given within 120 days of the occurrence of the injury, no compensation will be paid. Therefore, it is important to give notice of the injury as promptly as possible. Waiting even one day to notify your employer may cause the employer to doubt the legitimacy of your claim.

Worker's Compensation Process in West Chester

Proper notice includes how, what, where, when, and to whom.

As to how notice must be given, the only guideline is to “inform the employer.” Therefore, notice can be oral (in person or by phone, for example) or written (a letter or an email), as long as the employer has actual knowledge of the injury. The best practice is to tell the employer face-to-face and have the injury confirmed with an injury report. 

As to what, the employer must be informed that the employee received an injury in the course of employment.

When and where are obvious: the date and time of the injury and the location.

To whom means notice should be given to a supervisor of the employee, such as a foreman, or any agent of the employer regularly employed at the place of employment, such as a human resources or personnel administrator. It is not enough to say, “I'm hurt; I need to go to the doctor,” even if you think your supervisor saw you get injured.  Don't rely on this, as a supervisor may later say, “The employee never told me the injury was from work.” Tell your employer your injury was from your work.

How to Give Notice

Here are some other tips about giving notice of your injury:

  • Be complete and be consistent. It helps when the injury report and the history of injury given to the doctor are the same.
  • Report your injury to the proper person:
    • Telling your coworker is not notice.
    • Telling your spouse is not notice.
    • Telling your doctor is not notice.
    • Telling your lawyer is not notice.
  • Report the injury promptly. Although the Act allows you 120 days, even waiting 24 hours may cause the employer to question the credibility of your claim.

So, when reporting an injury, tell your supervisor what happened, how it happened, where it happened, and when it happened.      

The Bureau of Workers’ Compensation has many forms that are used to make a record of the status of your claim. The majority of these forms are for use by employers and insurance carriers. Most Bureau forms are designed to be simple and straightforward. Unfortunately, if they are not completed correctly, an employee’s rights may be compromised by the use of the wrong phrase or date. If you get a form from the insurance company, please call us to make sure that you know what you are signing.

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We are happy to review any form you get from the Bureau, your employer, or the workers’ compensation carrier. Please contact Kunkle and Sennett for more information.

Employers are supposed to post a list of approved medical providers (a “panel”) at your workplace so that you consult with one of these providers in the event you are injured at work. The employer is supposed to have the employee sign a notice form acknowledging that the employee knows about the panel providers.

Many employers fail to provide this list and also fail to provide the employee with the notice form to sign. Often the workers’ compensation carrier will send the notice form to the injured worker after the injury has been reported and will still insist that you treat with a member of their approved panel or face the possibility that the carrier will refuse to pay medical bills from an unapproved medical provider.

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This restriction is in place for the first 90 days after your injury. After 90 days, you may seek treatment with whatever provider you choose. Please remember, your health is more important than anything, and if you have questions, please call us so we can help protect your well-being.

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