Pennsylvania workers receive benefits through workers’ compensation after an injury on the job. Local laws require the employer to maintain insurance to provide these benefits. If the employer fails to comply with these requirements, the worker could file a formal claim to acquire workers’ comp in Pennsylvania.
How Are Claims Filed?
The employer sends the worker to the emergency room to acquire treatment, and the human resources department must provide the worker a claim’s form for the accident. The doctor completes the form and returns it to the insurer within a ten-day period. The form must reflect an exact description of the injuries and it should identify the exact recovery period and any limitations caused by the injuries.
The employer must complete an accident report and submit to their insurer. The report should explain the exact circumstances that caused the accident and whether or not the worker was compliant with work safety regulations when the accident occurred.
How Are Claims Evaluated?
The claim’s adjuster must evaluate the documentation to determine if the injuries meet the terms of the policy. If the worker is able to perform light-duty, they will receive medical coverage for their medical treatment. They won’t receive any monetary benefits for wage replacement. However, if they cannot perform any job functions, they receive workers’ compensation benefits for the full duration of their recovery.
What Happens If the Employee Is Denied Benefits?
Any worker with qualifying injuries that is denied benefits could file a formal claim against their employer. This lawsuit must provide the worker’s full medical records for their injuries along with a testimony explaining the accident and how it happened. If the employer wasn’t compliant with OSHA regulations, they are liable for the worker’s injuries. The court determines the full value of compensation awarded to the worker.
Pennsylvania workers are covered under the business owner’s insurance. Employers are required by law to maintain workers’ compensation insurance in the event of an accident, after which they must file a claim to acquire medical coverage for the worker. If they are denied, they have two years to file a formal claim. Employees who need help with a claim for workers’ comp in Pennsylvania should contact Swartzculleton.com today.
Watch our Video on YouTube.