WHEN SHOULD I REPORT MY WORKERS’ COMP CLAIM?
When Should I Report My Workers’ Comp Claim? How Much Time do I Have to File?
Are you wondering when you need to tell your employer about your work-related injury or illness? Do you have questions about what time frame you must follow in order to receive workers’ compensation benefits? Have you found yourself asking how quickly you must act in order to be eligible for workers’ compensation? We can help you with these answers.
It is very important that you notify your employer of your work injury as soon as possible. Frequently an insurance company will deny a claim if there was a lapse of time between the incident and when you actually report it to your employer. The best thing you can do is give prompt notice, not only verbally, but in writing to your supervisor. Notice to a co-worker is generally not deemed legally sufficient.If you wait too long to protect your rights, you may lose them.
Is There a Statute of Limitations (a deadline) for Filing a Workers’ Compensation Claim?
In Pennsylvania, there are strict statutes of limitations in workers’ comp. If you try to file a claim after the statute of limitations has expired,you could be barred from pursuing the benefits that you would have been entitled to as a result of a work-related accident or injury.
As an injured worker, you are entitled to receive payment of reasonable medical expenses as well as wage-loss benefits. In order to receive compensation, you must notify your employer within 120 days of the date of injury or of the date you became aware of your condition being work related. However, if you wait too long after the injury occurred, you run the risk of having the claim denied even though you are still within the 120 days for providing notice. Immediately following a work injury, the most important things for you to do are seek medical attention and notify your employer.
One exception to the 120-day rule is occupational disease such as cancer or chemical exposure and poisoning. In order to qualify for compensation in these situations, the employee must become injured or disabled within 300 weeks of the last date of exposure in the job that caused the occupational illness. Moreover, the injured worker must file a claim petition in court within three years of the date of injury or disability. Failure to act within three years for any work injury will result in a loss of eligibility for workers’ compensation benefits.
One of the reasons to notify your employer immediately is to gain access to medical attention. Depending on your workplace, your employer might have panel doctors or send you to a hospital. Even if you carry personal health insurance you should not have to use it to treat a work injury. Another reason to notify your employer is to fill out an incident report. It is important to document the work injury early to include details such as the time of the injury, the location, the manner in which it happened, and any witnesses to the incident.Once you notify your employer of the work injury and fill out an incident report, the employer’s insurance carrier has 21 days to either accept or deny your claim.
By notifying your employer immediately, you also eliminate any doubt that the injury happened within the course and scope of your employment. For example, if you injure your back at work and notify your employer the same day of your injury, you establish a timeline of events that will be difficult to disprove. On the other hand, if you wait until the next day or the following week to seek medical attention or notify your employer, you will have a harder time establishing the basic elements of your claim. The bottom line is that notifying your employer as soon as possible will boost the legitimacy of your claim.
It is also important that your workers’ compensation claim be filed correctly. The date of injury and manner of injury must be consistent through the paperwork. The description of injury should include all affected body parts. For example, if you fall at work and injure your head and arm, those should be mentioned in your description of injury and in complaints to your doctor. If instead you mention the head only and do not mention the arm until a later time, your employer might challenge that aspect of your injury and treatment and argue that it is not work-related.
Sometimes while treating a work injury, another condition might develop that arose out of the work injury. In those circumstances, there are ways to amend the description of an injury to include subsequent diagnoses. Initially, however, you have the burden of establishing that you were injured at work, so the better handle you have on the facts up front, the better off you will be.
If your employer’s insurance denies your claim, you will need to file a claim petition in court. The claim petition will include information regarding the date and description of the injury, as well as wage information. The statute of limitations for filing a claim in court is three years from the date of injury. If you were receiving workers’ compensation benefits and they were terminated, you have three years from the date of your last payment to file for reinstatement.
Can I be denied Workers’ Compensation Benefits if I Don’t Report My Injury in Time?
In the case Hershgordon v. Workers’ Compensation Appeal Board (Pep Boys), the appeal board reaffirmed the importance of notifying the employer within 120 days of injury. The claimant filed a claim petition for an alleged work injury occurring on June 13, 2005. The record showed that the employer was not notified of the alleged injury until September 11, 2007, well after the 120 days expired. The WCAB and Commonwealth Court both denied the claim.
In another case ruled on by the Appeal Board, Vicky Ross, Petitioner, v. Workers’ Compensation Appeal Board (Slender You of Leola), a woman claimed to have suffered a work-related disc herniation in May 2007. She said she had cleaned 42 tanning beds for her employer that day and felt numbness in an arm and fingers, as well as shoulder pain. The workers’ comp judge awarded her temporary total disability benefits, clearly believing that the injury was both severe and sustained on the job.The employer and its insurance company challenged the Judge’s decision and the Appeal Board reversed it,stating that the claimant waited until October 2007, more than 120 days after the injury,before making the report. Because Section 311 of Pennsylvania’s Workers’ Compensation Act requires an employee to report a work-related injury to the employer within 120 days, this claimant lost a significant award for a substantial injury.
Is there a Deadline for Getting Workers Comp Benefits Reinstated?
There are time limits for reinstating workers’ compensation benefits after the insurer suspends or terminates them. For suspended benefits, an employee with a partial disability must file a petition to reinstate benefits within 500 weeks of the date on the last benefit check. For terminated benefits, the employee must file a petition to reinstate benefits within three years of the date on the last benefit check.
When seeking workers’ compensation benefits, it is vital to act within the prescribed time limits. If you have suffered an injury while at work, seek immediate consultation with an attorney to discuss your eligibility for workers’ compensation benefits. If you wait, you risk losing your right to compensation.
Schedule a Free Initial Consultation to Learn More Information
In Pennsylvania, workers do not have unlimited amounts of time to pursue workers’ compensation claims. We can help you understand how much time you have to file a claim and what you need to do to be able to properly file in the state.
At Martin Law, we are concerned about the success of our clients. For a free case evaluation from a workers’ compensation attorney, call us today at 215.587.8400.
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