Sitting Down To Answer Your Questions About Workers’ Comp

We understand that if you suffered an injury at work, you probably have countless questions about workers’ compensation. From filing the initial claim to receiving your benefits, you are having a difficult time even making sense of it all. You can turn to our attorneys for answers. At Stark Law Group, we have more than 15 years of experience helping the injured workers of Lancaster. Below, you can read some of our answers to our clients’ frequently asked questions.

How much is my workers’ comp claim worth?

The amount of workers’ comp benefits you receive depends on the severity of your injuries. Minor injuries might require only a few hundred dollars in compensation. Claims involving severe, life-altering injuries may range into hundreds of thousands of dollars. When you sit down with a lawyer, you can get a better idea of your claim’s value.

How long will my case take?

Receiving your check in the mail usually takes a few weeks. In some cases where the insurance company denied a claim and you need to file a series of appeals, it may take years. We will try to make sure that your claim goes as fast as possible so you can receive benefits ASAP.

What if my claim is denied?

Do not give up hope. Thousands of workers’ comp claims receive denials the first time around. You have the right to file an appeal with your local Pennsylvania Workers’ Compensation Office. The second time around, it is crucial that you have an attorney to guide you through the steps, strengthen your claim and give you every advantage possible so you can recover the benefits you deserve.

Should I speak with the other driver’s insurance company if they call me?

Do not speak with any insurance company representatives. Insurance providers are for-profit companies. They do not want to pay the full settlement. Claims adjusters and other representatives sometimes use certain strategies to get you to admit fault, even if you had no part in the accident. Before you speak with anyone from the insurer, speak with a lawyer.

Frequently Asked Questions About What to Do After a Work Injury

What qualifies as a work-related injury?

A work-related injury generally refers to an injury or illness that occurs while you are performing duties connected to your job. This may include slip and fall accidents on company property, construction accidents, injuries involving heavy equipment, or other incidents that happen while performing work-related tasks.

Occupational illnesses and conditions that develop over time may also qualify. Examples can include asthma caused by workplace exposure, carpal tunnel syndrome, or the aggravation of a pre-existing medical condition due to job duties.

In Pennsylvania, it is important to report a work-related injury to your employer promptly and seek appropriate medical attention. Early reporting and medical documentation can help support your workers’ compensation claim.

Not every injury that occurs during work hours automatically qualifies as work-related. Generally, the injury must occur while you are performing duties for your employer or participating in an activity connected to your employment.

For example, injuries that occur during a break or lunch period may depend on where the injury happened and whether you were engaged in a work-related activity at the time.

Certain circumstances may also affect whether workers’ compensation applies. Injuries involving intoxication, horseplay, or activities outside the scope of employment may be disputed or excluded from coverage.

Some workplace injuries may also involve issues such as negligence, premises liability, or product liability. In those situations, an attorney can help determine whether workers’ compensation, another type of claim, or both may apply.

Proper medical documentation is especially important when a workplace injury results in surgery, long-term disability, a serious physical injury, or an aggravation of an existing condition. Understanding whether an injury qualifies as work-related can help protect your right to available benefits during your recovery.

How do you apply for workers’ compensation?

The first step after a workplace injury is to report the injury to your employer as soon as possible. Pennsylvania workers’ compensation claims are subject to important deadlines, and waiting too long to report an injury may affect your ability to receive benefits.

Prompt reporting also creates a record of when the injury happened and how it occurred. This documentation may become important if the insurance company later questions or disputes the claim.

After receiving notice of the injury, your employer should begin the workers’ compensation claim process. You should provide accurate information about the accident, the circumstances surrounding it, and the injuries or symptoms you experienced.

You should also seek appropriate medical treatment and keep records of your diagnosis, treatment, work restrictions, and any time you miss from work because of the injury.

The workers’ compensation insurance company will review the claim and determine whether benefits will be accepted or denied. Its investigation may involve medical records, interviews, medical evaluations, and other evidence related to the injury.

If the claim is accepted, workers’ compensation benefits may help cover medical treatment and lost wages related to the workplace injury. If your claim is denied or benefits are disputed, additional legal action may be necessary.

Because workers’ compensation claims can become complicated, consulting with an experienced workers’ compensation attorney can help you understand your rights and options. An attorney can also assist if benefits are delayed, denied, reduced, or challenged by the insurance company.

How much does a workers’ compensation attorney cost?

In Pennsylvania, workers’ compensation attorneys who represent injured workers generally work on a contingent fee basis. This means the attorney receives a fee if they secure or protect workers’ compensation benefits for the injured worker.

The law caps an attorney’s fee at 20% of a worker’s benefits.

There is no fee to consult with Attorney Stark about your workers’ compensation claim. If you are already receiving benefits and your claim is proceeding properly, an attorney’s fee may not be immediately payable.

Attorney fees generally become relevant when Stark Law Group must pursue benefits on a denied claim or actively defend existing benefits. This may happen, for example, if the insurance carrier argues that you have fully recovered or that you are able to return to work despite your medical provider’s recommendations.

This means you may be able to receive legal guidance about your claim without immediately losing a portion of the benefits you are already receiving.

An insurance adjuster may also offer a settlement, particularly when you have an ongoing claim and are currently receiving benefits. Before negotiating or accepting a settlement, it is strongly recommended that you speak with an attorney.

At Stark Law Group, you would only be charged a fee on the amount our firm secures for you above the amount you had already been offered before our involvement.

Do not let concern about attorney fees prevent you from getting the legal guidance you may need to navigate your workers’ compensation case.

What is the workers’ comp statute of limitations?

The workers’ compensation statute of limitations is the legal deadline for pursuing a claim for benefits after a workplace injury. Missing an applicable deadline can affect or eliminate your ability to recover benefits.

In Pennsylvania, the statute of limitations for many workers’ compensation claims is generally three years from the date of injury.

Different rules may apply in certain circumstances. For example, occupational disease claims may involve different timing considerations depending on when the condition developed or was diagnosed.

Because workers’ compensation cases are fact-specific, injured employees should act promptly and avoid assuming that they still have plenty of time to file a claim.

Missing a deadline may prevent an injured worker from pursuing benefits related to medical treatment, lost wages, disability, or other consequences of a workplace injury.

Other legal claims involving negligence, product liability, or premises liability may also have their own separate deadlines. This can become especially important when a workplace accident involves someone other than the employer.

An experienced workers’ compensation attorney can help determine which deadlines apply, prepare required paperwork, communicate with insurance companies, and represent you if a dispute must be presented to a workers’ compensation judge.

If you have questions about a deadline or believe time may be running out, contact Stark Law Group as soon as possible to discuss your situation.

Frequently Asked Questions About Workers’ Compensation Benefits

What types of injuries are covered by Workers’ Compensation?

Workers’ Compensation is designed to protect employees who suffer work-related injuries or illnesses. It may cover a wide range of physical injuries that occur during the course of employment, regardless of fault.

Common examples include sprains, fractures, burns, back injuries, traumatic brain injuries, amputations, and injuries caused by slips and falls, construction accidents, machinery, or repetitive motion.

Repetitive stress injuries, such as carpal tunnel syndrome, may also qualify if they are related to an employee’s job duties. Occupational diseases caused by exposure to hazardous materials or workplace conditions may also be covered.

In some circumstances, mental health conditions may qualify for Workers’ Compensation benefits when they are directly related to workplace duties or incidents. These may include conditions such as anxiety, depression, or post-traumatic stress disorder (PTSD).

A work-related aggravation of a pre-existing condition may also support a claim. For example, an employee with an existing back condition may still be eligible for benefits if work activities significantly worsen that condition.

Employees should report work-related injuries or illnesses promptly and seek appropriate medical care. Medical records, diagnoses, treatment plans, and documentation of how the condition affects your ability to work can become important evidence in a Workers’ Compensation claim.

If a claim is denied or disputed, a Workers’ Compensation attorney can help review the medical evidence, explain your rights, and represent you during the claims or appeals process.

Workers’ Compensation benefits may extend beyond medical care and wage replacement. Depending on the circumstances, an injured worker may also be eligible for disability benefits, specific loss benefits, or other compensation related to a serious or permanent injury.

In cases involving catastrophic injuries or a work-related death, additional benefits may be available to the injured worker or eligible family members.

Can I receive Workers’ Compensation benefits if my injury was my fault?

Workers’ Compensation is generally a no-fault system. This means employees may be eligible for benefits for a work-related injury even if their own actions or negligence contributed to the accident.

The purpose of the system is to provide injured employees with access to medical treatment and wage loss benefits without requiring them to prove that their employer caused the accident.

However, there are exceptions. A claim may be challenged or denied if the injury resulted from certain types of conduct, such as intoxication, intentional self-harm, or activities outside the scope of employment.

Injuries involving horseplay, serious violations of workplace rules, or conduct unrelated to job duties may also raise questions about whether Workers’ Compensation applies.

Injured workers should report the accident promptly and seek appropriate medical care. Medical records, accident reports, witness information, and other documentation can help establish how the injury occurred and how it relates to the employee’s work.

Questions about fault can become especially complicated when an injury involves a third party. For example, an employee injured in a vehicle accident while performing job duties or hurt by defective equipment may have rights beyond a standard Workers’ Compensation claim.

In some situations, an injured worker may be able to pursue a separate claim against a negligent third party while also receiving Workers’ Compensation benefits.

A Workers’ Compensation lawyer can help determine which claims may apply and how to protect your rights throughout the process.

What should I do if my Workers’ Compensation claim is denied?

A denied Workers’ Compensation claim can be frustrating, but a denial does not necessarily mean the case is over. The first step is to carefully review the denial notice from the insurance company.

The notice should identify why the claim was denied. Common reasons may include insufficient medical evidence, questions about whether the injury was work-related, disputes about when or how the injury occurred, or issues involving notice or documentation.

Once you understand the reason for the denial, gather any evidence that may support your claim. This can include medical records, accident reports, witness statements, work restrictions, and correspondence with your employer or the insurance company.

You should also speak with your treating medical provider to make sure your records accurately document your injury, diagnosis, treatment, and relationship between the condition and your work.

If you decide to challenge the denial, the process may involve filing a petition through the Pennsylvania Workers’ Compensation system. Deadlines and procedural requirements can apply, so it is important to act promptly.

A disputed claim may involve hearings, medical evidence, depositions, expert testimony, mediation, or other legal proceedings before a Workers’ Compensation Judge.

Because the process can be complicated, many injured workers choose to work with a Workers’ Compensation attorney after a claim is denied. An attorney can help prepare the necessary documents, gather evidence, communicate with the insurance company, and represent you during hearings or negotiations.

An attorney may also help determine whether settlement or mediation is appropriate. In some cases, the facts may also support a separate third-party claim involving negligence, a vehicle accident, defective equipment, or another responsible party.

Throughout the process, keep detailed records of your medical treatment, communications, work restrictions, and any impact the injury has on your ability to work.

If a denied claim is later approved, you may be eligible for benefits covering certain medical expenses or wage loss related to the period when benefits were not being paid.

If your Workers’ Compensation claim has been denied, contact Stark Law Group to discuss the reason for the denial and the options that may be available to you.

More Questions? Ask Us In Person.

We hope that these answers gave you some of the guidance you needed. Granted, you probably have dozens of other questions about workers’ compensation. When you speak with one of our team members in an initial consultation, you will receive advice regarding your rights and your options. Call us at 717-844-6350 or send us an email to set up that initial consultation.