Frequently Asked Questions About Pennsylvania Workers’ Compensation
At Cullen Legal, we understand that you have many questions about your workers’ compensation claim – the process can be very complicated. We are here to provide answers to your questions and attention to your concerns.
I got hurt on the job. How much can I expect to get in workers’ compensation benefits?
If your injury results in a decrease in your weekly earnings then you should receive benefits to represent your wage loss. This means that you may be eligible for benefits even if you are still working – but earning less due to the work injury. Your amount will depend on how much money you earned in the year prior to your work injury. Your maximum weekly benefit is then calculated based on a statutory rate schedule. There is no cost of living increase for your weekly wage loss benefits.
What else does workers’ compensation pay for?
In addition to your weekly wage loss benefits, workers’ compensation pays for your medical treatment.
Is this all that I am eligible for?
That depends. Some injuries may also receive compensation as a result of a “specific loss.” Specific losses refer to injuries that cause disfigurement above the collarbone (i.e., from a laceration, burn or scar) or result in the loss of use of a body part (i.e., an amputation or hearing loss). Other benefits are also available, but generally speaking, workers’ compensation only provides for the payment of wage loss benefits, medical benefits and specific loss benefits.
I was laid off after getting hurt at work. What happens now?
Generally speaking, an employee working with restrictions, due to a work injury, should have their workers’ compensation benefits reinstated when laid off. Typically, the amount received from workers’ compensation benefits is higher than what they would receive from unemployment compensation. If you have been receiving unemployment compensation but feel that you are entitled to workers’ compensation benefits, give Cullen Legal a call today. Plant closures, layoffs, furloughs and terminations will impact employees differently depending on the facts of their case.
I have had a serious injury at work. What is my next step?
First, seek medical treatment for your work injury. Second, give your employer and their insurance company a chance to do the right thing and for the workers’ compensation process to work. However, when things calm down, give Cullen Legal a call. We will review your claim and make sure that all is in order. Generally speaking, the more serious the claim, the fewer problems you will have during the initial phase of your claim. Unfortunately, these claims tend to become problematic as time passes, because what was at first “unimportant” may become quite significant with the passage of time.
Should I apply for workers’ compensation benefits or Social Security Disability?
For a person who is hurt at work, the decision to apply for benefits from workers’ compensation or Social Security Disability Insurance is a simple decision to make. You should apply for benefits from both. This is because a work injury that disables you from work makes you eligible for workers’ compensation benefits. If you meet Social Security’s definition of “disabled,” you are also eligible to receive Social Security Disability benefits. Assuming that you are awarded both workers’ compensation and Social Security Disability benefits, your Social Security Disability benefits will be reduced to take into account the fact that you are receiving workers’ compensation benefits. However, you will receive more in workers’ compensation and Social Security Disability benefits combined than if you were only to receive benefits from workers’ compensation or Social Security Disability alone.
My employer wants me to sign off on some documents that talk about my work injury. What should I do?
Tell them that you will be more than happy to sign off on the form after you have had the opportunity to review the form with your attorney. Then, please contact Cullen Legal for your free consultation. We will review the form with you to make sure that it accurately reflects the facts of your claim.
How do you get paid for workers’ compensation cases?
Workers’ compensation attorneys are generally paid on a contingency basis. This means we do not get paid unless you do. The standard fee for all lawyers is 20%. On occasion, the employer can be made to pay the fee if they contest a claim unreasonably.
An attorney’s fee always has to be approved by a judge. Once it is approved, your employer’s insurer will deduct our fee from your weekly indemnity check or lump sum settlement. The insurer will then send the attorney’s fee directly to us.
However, keep in mind that even before Cullen Legal takes a case, all consultations are free. We also take care of all out-of-pocket legal expenses such as deposition fees, expert reports, the cost to obtain medical records, transcripts, etc.
How long will my claim be in litigation?
While efforts are being made to reduce the amount of time that a claim is in litigation, the entire litigation process normally takes just over a year.
Please note that the same claim usually goes in and out of litigation several times. You may have to litigate whether or not you are eligible to receive workers’ compensation benefits. You may have to litigate whether or not your benefits should be terminated based on a full recovery or suspended based on an ability to return to work. You may also have to litigate issues involving problems with the payment of your workers’ compensation benefits (i.e., the checks stop coming), medical benefits (i.e., medical benefits may be denied), and whether or not your medical treatment is reasonable and necessary.
During this litigation process, it is important that you have an attorney to represent your interests. Judges almost always will provide you with an opportunity to hire an attorney if you do not have one.
Can I settle my claim for a lump-sum payment?
Absolutely, as long as you and your employer’s insurer can agree on an amount. However, you are not entitled to a settlement. An experienced workers’ compensation attorney can often bring a reluctant insurance company to the table to negotiate a fair settlement. Settlement of a claim is also something that you should not take lightly. An inexperienced attorney or an unrepresented employee may resolve the claim for significantly less than what the claim is actually worth, leaving money on the table.
You can also choose to settle your entire claim or parts of your claim. Your employer’s insurer will probably want to resolve the entire claim at one time, so that they can “close” your file once and for all. To the extent that you settle your claim, you will not be able to reopen that part of your claim in the future.
If you are interested in resolving your claim through settlement, then please give us a call. We’ll review your claim with you, and walk you through the entire process to make sure that settlement is in your best interest.
What should I do? Nobody will return my phone calls.
In these times of corporate downsizing, many employers and adjusters are taking longer to return calls. However, your calls should be returned in a reasonable amount of time. To expedite the process, make sure that you provide them with your current contact information each time you leave a message.
If you do not receive a timely response, then ask someone to try calling on your behalf — like your supervisor at work.
If you are still not getting a response, then call us. It’s amazing how often our calls are answered right away. Our goal is to always provide you with timely and responsive answers to your questions.
Help! The only one who calls me is a collections agency looking for payment of an outstanding medical bill.
First, call your medical provider and ask them why they referred your bill to a collection agency. Remind them that bills for your work injury are the responsibility of your employer’s workers’ compensation insurer. Ask them to resubmit the bills directly to the insurer and to copy you in on that correspondence. This will generally resolve the problem.
If it does not resolve the problem, then please contact Cullen Legal. Unpaid medical bills can pile up over time and should be addressed sooner rather than later. There are several reasons why bills might be unpaid. For example, the bills may not be related to your work injury, your insurer may be slow in making payment, or your insurer may have suspended payment while a determination is being made to see if the treatment is reasonable and/or necessary. Depending on the specifics of your case, we can work with you and your medical provider to see that your insurer pays for all reasonable and necessary medical treatment that is related to your work injury.
Can I reopen my old claim?
It depends. Some claims can be reopened if you have a “recurrence” of your old injury. Sometimes these old injuries are “aggravated” and a new claim needs to be filed. Determining whether or not you should proceed under your “old” claim or should file a “new” claim is a significant decision that can impact your rights to receive workers’ compensation benefits. Our attorney will be happy to review your claim and medical records with you during your free consultation so that the proper choice can be made.
I can’t understand what people are saying – too many abbreviations and “legalese.”
This is not uncommon. Employers, adjusters, doctors and lawyers all use buzzwords. Feel free to take a look at our glossary for an explanation of some of the common terms and abbreviations.
If you still do not understand what is being told to you, then feel free to come in for an appointment. During your free consultation, we’d be happy to review your claim with you — in terms that everyone can understand.
If you literally need a translation from English to another language, then we can help. We routinely work with a number of translators.
How do I get to my doctor when I can’t drive?
Unfortunately, this is a common problem. You want to go and treat for your work injury, but you can’t get to your doctor because of transportation problems. You don’t have a car, mass transit is not available, SEPTA’s Paratransit Service is not adequate for your needs and you can’t afford to pay for a taxi.
We’d be happy to work with you and your employer’s insurer to try to work something out so that you can get the medical treatment you need.
What do I do if I know someone who died at work or I think that their death was caused by the type of work that they were doing?
If there is a concern that someone died as a result of their employment, then contact Cullen Legal immediately. We will sit down with you to see if there is medical evidence to support relating their death to work. Sometimes, the relationship is obvious. Other times, it is not. For example, cancers may take years to develop. A heart attack or stroke may occur hours or days after someone stopped working.
When someone has died as a result of a work injury, their spouse and dependents may be entitled to workers’ compensation benefits. We have both the experience and compassion to help deal with this type of situation.