Filing a Worker’s Compensation Claim in Pennsylvania:

A workers’ compensation claim is filed by notifying your employer of your work-related injury. Report the injury you have sustained. The application for benefits is given to the employer.

If your employer declines to accept liability, you may call the Workers' Compensation Division (1-800-528-5166) and ask to speak to an Examiner.

You have the right to obtain the services of an attorney to handle the claim in the courts as provided by the law.

In Pennsylvania, attorney fees in work injury cases are limited to 20%. If you settle for $30,000, your lawyer’s fee would be $6,000. An attorney cannot receive a fee larger than 20%, which means that you can go with the best attorney you can find. Note that there is no limit to what you can recover in a Pennsylvania work injury case, unless you have a “specific loss” claim (loss of all or part of the use of a limb, or your sight or hearing, for example).

Upon suffering an injury, you have 21 days to report the injury to your employer. If 120 days elapse from the date of your injury or the date that you became aware that you had a work-related illness, then there is no compensation allowed under the Act.

Your employer then has to inform its insurance provider of the incident and to file a First Report of Injury with the Bureau of Workers’ Compensation within 7 days (that is reduced to 48 hours if there is a fatality).

If the insurer denies the claim, you will receive a Notice of Workers’ Compensation Denial within 21 days, and that will conclude the process.

Pennsylvania Worker’s Compensation Benefits:
Pennsylvania is a “no fault” state, which means that you are entitled to benefits regardless of whether it was your employer’s fault that you got hurt. Even if your injury was caused by your mistake, you are entitled to benefits. You do have to prove that your work caused your injury. There are a few exceptions, such as if you were intoxicated at the time of your injury. In most cases, you cannot sue your employer for negligence.

Wage-loss benefits are available if it is determined that you are totally disabled and unable to work or partially disabled and receiving wages less than your pre-injury earnings. Please see the "Total and Partial Disability Benefits Status" section for further information as to disability status.

If the injury results in death, surviving dependents may be entitled to benefits.

Specific Loss Benefits
If you have lost the permanent use of all or part of your thumb, finger, hand, arm, leg, foot, toe, sight, hearing, or have a serious and permanent disfigurement on your head, face or neck, you may be entitled to a specific loss award.

Medical Care
Employers are responsible for advising workers of their rights and duties under Section 306(f.1)(1)(i) of the Act (medical benefits). The written notice of these rights and duties is to be provided to the employee at the time of injury or as soon after the injury as is practicable.

In the event of a work-related illness or injury, you are entitled, if covered under the Act, to the payment of related reasonable

surgical and medical services rendered by a physician or other health care provider.

Medicine, supplies, hospital treatment and services, orthopedic appliances, and prostheses are also covered for as long as they are needed. Even if you have lost no time from work, health care costs for a work-related injury or illness are payable at the fee schedule rate. However, an employee may not be charged the difference between the health care provider's charge and the amount paid by the employer or its insurance carrier. In other words, there can be no "balance billing" to you.

Pennsylvania Worker’s Compensation Treatment:
An injured worker has the freedom to choose his or her treating physician and may switch from one specialty of care to another without having to seek approval of the employer/insurer. The worker must, however, have permission to switch from one provider to another within the same field of specialty.

While the injured worker has the freedom to select the treating physician, the physician must have approval from the employer/ insurance carrier to continue treatment beyond $750 worth of care unless the care is provided under emergency conditions. However, the withholding of such consent is not to be arbitrary and capricious or without probable cause.

Pennsylvania Worker’s Compensation Waiting Period:
The waiting period for compensation benefits after the injury is 7 days.

Compensation is retroactive if disability continues for 14 days or more from the date of injury.

Pennsylvania Worker’s Compensation Contact Information:
John T. Kupchinsky, Director
Bureau of Workers’ Compensation
Department of Labor and Industry
1171 So. Cameron Street, Rm. 324
Harrisburg, PA 17104-2501
 (717) 783-5421  (717) 783-5421 or  1-800-482-2383  1-800-482-2383

NOTICE: These questions and answers concern Pennsylvania law only, and should not be construed nor relied upon as reflecting the law in other States, nor as giving legal advice. You are warned that circumstances often vary greatly and that, due to changing decisions and law, the answers to these questions may change over time and not be current, and you should consult an attorney in any specific case, and NOT rely on these questions and answers as giving anything other than general information.