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PA Workers’ Compensation Fast Facts: The Flow of a Pennsylvania Workers’ Compensation Claim in a Lit

By: Kevin J. McGarrey

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The Department of Labor and Industry has enacted procedures to make sure all Workers’ Compensation cases in Pennsylvania are handled uniformly. Most of the time your employer will “pick up” your WC claim and things will progress outside of the court system. However, there are occasions when the injured employee and the employer disagree about the injury and the employer’s liability to compensate the employee for the injury.

In cases where the employer and employee can’t agree, the cases are referred to the Department of labor and Industry’s court system. The following is an outline of how litigated cases will progress through the system.

1. Notice of Injury: Employers are required to post form LIBC-500, Remember: It is Important to Tell Your Employer About Your Injury, to inform employees of the name, address and phone number of their workers’ compensation insurance company, their third-party administrator or internal workers’ compensation contact person.

2. Injury: An employee injury is to be reported to the employer within 21 days; if not reported within 120 days from date of injury or having knowledge of a work-related disease, no compensation is allowed (except for cases involving progressive diseases).

3. First Report of Injury: Employers are required to immediately report all employee injuries to their insurer or, if self-insured, to report them to the person responsible for management of the employer’s workers’ compensation program. Employers are also required to file a First Report of Injury (formerly Employer’s Report of Occupational Injury or Disease) with the Bureau of Workers’ Compensation within 48 hours for every injury resulting in death, and within seven days for all other injuries which result in disability lasting more than a day, shift or turn of work. This document must be submitted electronically.

a. Voluntary Payment: Within 21 days from the date the employee provides notification of an injury, the employer/carrier accepts liability for the injury and issues a Notice of Compensation Payable, a Notice of Temporary Compensation Payable or an Agreement for Compensation. See the Flow of a Pennsylvania Workers’ Compensation Claim on page 6 for more detailed information.

OR
b. Denial of Payment: Within 21 days from the date the employee provides notification of an injury, the employer/ carrier denies liability and issues a Notice of Workers’ Compensation Denial to the employee.

4. If Denied: Generally, the employee has three years from the date of injury to file a Claim Petition (LIBC-362). The law also provides that injured workers may reopen their claim within three years from the last date an indemnity payment was made on a claim. (Mere paying of medical benefits would not be the same as reopening the claim.)

5. Assignment to a Workers Compensation Judge: Workers’ compensation petitions are normally assigned to a workers’ compensation judge by the bureau according to the county in which the employee lives.

6. WC Hearing Held: Once assigned, all parties involved in the case are notified in writing as to the date, time and place of hearing. A workers’ compensation judge hears evidence presented by both the defendant (employer/insurer) and claimant at one or more hearings which may be extended by the need to obtain medical evidence and hear other witnesses.

a. The workers’ compensation judge will schedule the case for mediation, unless the judge concludes it would be futile. If this mediation does not take place or lead to settlement, the parties may at any time ask for an informal conference or settlement conference with a workers’ compensation judge.

7. Decision Rendered: A written decision is circulated to involved parties after a case is closed (all evidence has been submitted and the judge has everything necessary to render a decision). No further action is taken.

8. Appeal: Either party has 20 days from the date the workers’ compensation judge’s decision is circulated to all parties to file an appeal with the Workers’ Compensation Appeal Board.

9. Appeal to Commonwealth Court: Either party has 30 days from the date of circulation of the Workers’ Compensation Appeal Board’s decision to file an appeal with the Commonwealth Court.

10. Appeal to PA Supreme Court: Either party has 30 days from the date of circulation of the Commonwealth Court’s decision to file a Petition for Allowance of an Appeal with the Pennsylvania Supreme Court.

Article Source: http://depositarticles.com/

Kevin is the writer of “PA Workers’ Compensation Fast Facts: The Flow of a Pennsylvania Workers’ Compensation Claim in a Litigated Case” www.pacomplawyers.com/Chester_County.html”> West Chester workers compensation lawyer Best online www.pacomplawyers.com/Chester_County.html”> PA Work Injury Lawyer

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