Areas Served
Workplace injuries are a common occurrence in the United States. Recent Bureau of Labor Statistics data shows that 2.8 million injuries and illnesses occurred in 2022. In Pennsylvania,123,400 workers suffered a job-related injury or illness that year.
If you were injured at work as a result of carrying out your job functions, you may be entitled to workers’ compensation benefits. Stine & Associates is prepared to assist you with your claim.
Founder and attorney Cindy Stine has more than 30 years of experience in providing counsel and representation to Pennsylvania workers who have suffered an injury or illness.
Although we’re based in Irwin — the “Biggest Little Town In Pennsylvania” — we serve clients throughout the state’s central and western regions.
Don’t be intimidated by the complicated laws and procedures surrounding workers’ compensation. It’s important that you understand your rights under Pennsylvania’s workers’ compensation law and the benefits you may be entitled to.
An Overview of Workers’ Compensation in Irwin, PA
The Pennsylvania Workers’ Compensation Act, enacted in 1915 and later amended, provides a series of requirements and procedures that today govern the state’s workers’ compensation system.
This system aims to ensure that every worker, regardless of fault, will not have to pay out of pocket for medical treatment or lose income when they are injured or fall ill as a direct result of performing their job responsibilities.
One key provision of the law requires all Pennsylvania employers to provide workers’ compensation coverage to their employees, part-time, full-time, and seasonal workers. The only exceptions are federal civilian employees, railroad, shipyard, and harbor workers, agricultural and domestic workers, and volunteers.
Employers mandated to provide workers’ compensation insurance obtain it through a private insurer or Pennsylvania’s State Workers’ Insurance Fund. Regardless of how they secure it, an employee receives coverage on their first day of employment, and it expires on their last day with the employer.
A worker who experienced a work-related injury or illness has a critical responsibility under the law. That is to report it to their employer in a timely manner to receive benefits, within 21 days starting on the day they sustained the injury or illness.
Except in a few circumstances, an employee who waits 120 days or more to report it loses their chance to seek a workers’ compensation claim.
The Pennsylvania Workers’ Compensation Act also tasked the Department of Labor & Industry and the Bureau of Workers’ Compensation with administering and handling appeals. Both are located in Harrisburg, the state capital.
What Injuries Are Covered?
Pennsylvania’s Workers’ Compensation Act defines the types of injuries and illnesses that are covered. Injuries fall into three categories. One, the injury was caused by a specific incident. A slip-and-fall, for instance, is a specific incident that results in injury and is one of the leading causes of workplace injuries.
In the second category is an injury resulting from repetitive actions. An example is carpal tunnel, a condition linked to repetitive motion of the hand and wrist.
The third category is a pre-existing condition, such as arthritis, a fracture, or a back or neck injury, that becomes aggravated over the course of a worker’s current role.
Pennsylvania workers’ compensation is a no-fault system. That means the law entitles a worker to benefits regardless of whether they caused the accident or illness. However, an injury or illness may not be covered if it was self-inflicted or caused by alcohol or drug intoxication, recklessness, or criminal activity.
Occupational Diseases
Some conditions are known to develop in specific occupations, such as firefighting, nursing, and mining. Known as occupational diseases, Pennsylvania’s Workers’ Compensation Act specifically names those that are covered. They include, but aren’t limited to:
- Poisoning (i.e., arsenic, lead, mercury, phosphorus)
- Asbestosis
- Tuberculosis
- Hepatitis C
- Heart and lung disease
- Coal workers’ pneumoconiosis, anthraco-silicosis, and silicosis
- Epitheliomatous cancer or ulceration caused by tar, pitch, bitumen, mineral oil, or paraffin
- Certain infections or inflammation of the skin
If you’re uncertain about whether your injury or illness or the circumstances surrounding the incident meet the state’s workers’ compensation benefits criteria, Stine & Associates will provide you with guidance. We’ll assess your case to determine whether it qualifies.
Workers’ Compensation Benefits
The law provides four types of benefits: medical care, compensation for lost wages, specific loss and disfigurement benefits, and death benefits.
Medical benefits cover the cost of “reasonable” medical and surgical services, medications, supplies, hospital treatment, and orthopedic devices and prostheses.
After reporting an injury or illness to their employer, the employer will provide a list of medical providers the worker can visit to seek treatment. The employee must select one from the list for their initial visit, rather than seeking treatment at a facility of their choice.
A worker is eligible for compensation for lost wages if the injury causes total disability, making them unable to work, or partial disability if the condition forces them to take a position in which they earn less in wages compared to what they earned prior to the injury.
An employee with a total disability (a minimum of 35% impairment) may receive two-thirds of their average weekly wages. After 104 weeks of receiving benefits, the employer may request a medical exam to confirm the disability rate.
A worker with a partial disability receives two-thirds of the difference between their average weekly wage before the injury or illness and the average weekly wage earned from the lesser-paying position.
The specific loss benefit is available to workers who lose part or all of a thumb, finger, hand, toe, or foot. An employee who loses all or part of their sight or hearing may also be eligible for this benefit. A disfigurement of the head, face, or neck also qualifies, though there’s no set payment amount.
When an injury or illness causes death, the worker’s spouse may be eligible for death benefits. They may receive 51% of the employee’s weekly wages, with the amount increasing depending on the number of dependent children. In addition, the death benefits provide up to $3,000 for burial expenses.
The Role of a Workers’ Compensation Attorney
An employee has the right to pursue a workers’ compensation claim without an attorney. However, given the complexities of the law and procedures, and the risk of claim denial, having a legal ally on their side—especially when the insurance provider or employer will have a lawyer on their team—is advantageous.
A workers’ compensation attorney will:
- Evaluate the incident and the injury or illness to determine eligibility
- Investigate the incident and collect evidence to support the claim
- Help complete the paperwork according to the deadlines
- Negotiate with the insurance provider
- Handle the dispute or appeal if a claim is rejected
If an employee decides to hire an attorney, Pennsylvania workers’ compensation law requires that the fee agreement be approved by workers’ compensation judges or the Workers’ Compensation Appeal Board.
Do You Need a Workers’ Compensation Attorney?
If you need an attorney to assist you with your workers’ compensation claim, contact us online or call for a consultation. We’re prepared to guide you every step of the way.