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Do I Qualify for Workers’ Compensation After a Work-related Injury or Illness?

 Pennsylvania’s Workers’ Compensation could provide you with two-thirds of your regular pay and medical care after an on-the-job injury or occupational illness.

On-the-job injuries and occupational illnesses happen all the time. A worker could fall off scaffolding at a construction site. A delivery service truck could be rear-ended at an intersection. A worker installing and cutting granite countertops could suffer silicosis. There are also death benefits to family members if a worker’s death is work-related. Most, but not all, employees are covered under the system.

Compared to a personal injury claim, what you can recover financially through workers’ compensation is less, but there’s no need to show your employer’s at fault to qualify for benefits. If your injury or illness was at least partially caused by someone other than your employer (such as a subcontractor’s employee at a worksite or the manufacturer of a defective product), you may be able to sue them to receive compensation for your injuries while maintaining a workers’ comp claim against your employer.

The advice of a lawyer can help you navigate the process, healthcare benefits and payments you may be entitled to.

Workers’ compensation basics

Benefits are paid by private insurance companies, third-party administrators, or the State Workers’ Insurance Fund (a state-run workers’ compensation insurance carrier) or by self-insured employers. If you are injured at work or diagnosed with an occupational illness, notify your employer as soon as you can, no later than 120 days after the injury. The longer you take, the higher the chance you claim will be denied or your benefits delayed.

The employer may accept or deny the claim. If it’s rejected, with the help of a lawyer, you can petition the state’s Department of Labor and Industry’s Bureau of Workers’ Compensation for a hearing before an agency judge. You have three years from your injury to file a claim petition.

Types of benefits

There are benefits if you are totally or partially disabled due to your injury or illness:

  • Total disability: Your injury or illness is severe enough that you’re considered totally disabled and unable to work. After 104 weeks, you can be required to take a medical exam to determine if you’re at least 35 percent impaired. If not, your status will be partial disability.
  • Partial disability: This is available up to 500 weeks. If you get an impairment rating equal to or greater than 35 percent, you may seek total disability status. Partial disability benefits are paid if you can, or do, come back to work to a lower paying job that meets your restrictions or if you are found not totally disabled

Social Security Disability Insurance benefits

If you are totally disabled and unable to work for at least a year, you may also qualify for Social Security Disability Insurance (SSDI) benefits. You and certain family members may receive benefits if you worked long enough, recently enough, and paid Social Security taxes on your earnings. If you worked “under the table,” were paid cash, and didn’t pay these taxes, you won’t qualify. If that’s the case, you have limited income and assets, you may instead be eligible for Supplemental Security Income (SSI) benefits.

A serious injury at work shouldn’t mean you can’t pay your bills or support your family. If you qualify, workers’ comp or SSDI may help you through a tough time and allow you to get back on your feet financially.

Attorney Neal Newman has represented clients in Pennsylvania for over 45 years. If you need an experienced attorney to help guide you through the workers’ compensation process or personal injury matters, Attorney Newman is ready to help. Contact The Law Office of Neal E. Newman today to schedule a consultation. Call 215-355-7260 or 267-566-0173 or fill out the contact form.


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