Pennsylvania Workers Compensation Handbook. Know Your.» Workers Compensation» Social Security Disability» Long-Term Disability

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1 Pennsylvania Workers Compensation Handbook Know Your Rights!» Workers Compensation» Social Security Disability» Long-Term Disability

2 Introduction Chances are this booklet has landed in your hands because you or someone you know has suffered a disabling work-related injury. You understand that beyond managing the physical issues related to that injury there are also a host of legal issues and processes to navigate at the same time. It can be overwhelming. This guide is meant to help you understand the rights of an injured worker, the litigation process and the possible settlements available to bring the issue to a resolution. As comprehensive as this guide is, make no mistake: your best choice is always to be represented by an experienced attorney. After all, employers and insurance companies have their own legal representation. Martin llc was established in 1979 and is one of the largest firms in Pennsylvania focusing its practice on Workers Compensation and Social Security Disability. Here, workers are not only represented by attorneys with substantial experience in those areas of the law, but an entire legal team, from your initial interview with a client intake specialist to all of the medical and administrative professionals supporting you throughout the claims process. Knowing that our skilled team is behind you is empowering. And that alone helps the healing process, enabling you to turn your focus to your future. Of course, this handbook is not meant to be a substitute for legal advice, since laws and processes are always changing. But the fact that it is in your hands right now means that you are headed in the right direction: that is, getting the benefits to which you are entitled. Thank you for considering Martin llc to help you in that regard. 1

3 Table of Contents Chapter One: The Law The Workers Compensation Act... 4 Can I Sue My Employer?... 5 Injuries Covered by the Act... 6 Employees Covered by Act... 7 Occupational Illnesses or Disease... 8 Notice: Reporting Your Injury... 8 What Does Workers Compensation Pay?... 9 Average Weekly Wage (AWW)...10 Types of Benefits: Total Disability Benefits...13 Partial Disability Benefits...13 Specific Loss Benefits...14 Death Benefits...15 Travel Expenses...15 Medical Treatment...16 Bureau Documents: Medical-Only Notice of Compensation Payable, Notice of Compensation Payable & Statement of Wages...17 Notice of Temporary Compensation Payable (NTCP)...18 Notice of Compensation Denial (NCD)...18 What to do if you return to work?...19 Signing Documents...19 Reduction in Workers Compensation Benefits Due to Receipt of Other Benefits Social Security Disability Retirement

4 Chapter two: the Litigation Process The Petition The Hearing Appeals Insurance Medical Exams...24 Impairment Rating Evaluation...24 Utilization Review Vocational Rehabilitation Labor Market Survey Chapter Three: Settlements Settlements Mediation: Mandatory Voluntary Subrogation Child Support and Act Sample Forms & notices Statement of Wages Notice of Workers Compensation Denial Notice of Compensation Payable Notice of Temporary Compensation Payable (NTCP) & Notice Stopping Temporary Compensation Notice of Ability to Return to Work Notice of Suspension or Modification Pursuant to 413 (C) & (D) Employee Verification or Employment, Self-Employment or Change in Physical Condition Employee s Report of Benefits for Offsets (Unemployment Compensation, Social Security [Retirement] and Pension Benefits).48 Your Most Important right About MArtin llc

5 Chapter One: the law The Workers Compensation Act Originally passed in 1915, the Pennsylvania Workers Compensation Act is a statewide, no-fault insurance system of benefits designed to compensate all injured workers for lost wages and medical expenses. The system was not designed to replace all of the wages lost by the injured worker, but only a percentage of those wages in a nontaxable form of weekly or bi-weekly benefits. The Workers Compensation Act does not provide for non-economic damages such as pain and suffering. It pays for all injuries and occupational diseases that occur during the course and scope of one s employment. The only recourse an employee has against his or her employer when injured on the job is through the Workers Compensation Act. The laws governing workers compensation were dramatically changed on June 24, Those amendments (commonly known as Act 57 ) made it more difficult for the injured worker to be paid benefits and gave employers more control over injured workers. The laws governing workers compensation were once again amended on November 9, 2006, through Act 147, with the intent to help injured workers in Pennsylvania. Every employer in the Commonwealth of Pennsylvania is required to carry workers compensation insurance. Some employers are selfinsured, which means that they have to post a bond and pay benefits out of their own bank accounts. Through Act 147, the Uninsured Employers Guaranty Fund was established to pay a claim brought 4

6 Your Most IMPortANt Right The most important right you possess as a citizen of this country and resident of the Commonwealth of Pennsylvania is your RIGHT TO VotE. Unless you are registered to vote, know who your state representatives are and where they stand on issues involving injured workers, and vote for those who want to protect injured workers and disabled individuals, more rights will be taken away. We encourage you to contact your state representative and tell him or her not to vote for any law that is harmful to those who are disabled. If you aren t sure who your state representative is, visit or call us. If you need voter registration forms, we will be happy to provide them to you as well.

7 Pennsylvania Workers Compensation 1818 Market Street, 35th Floor Philadelphia, PA branch offices Malvern Reading Allentown by appointment only locations Northeast Philadelphia Media Harrisburg main fax toll free PA-COMP1 ( ) web paworkinjury.com

8 COPYRIGHT 2013 Martin LLC, 1818 Market Street, 35th Floor Philadelphia, PA Phone: No part of this handbook may be copied or reproduced in any manner whatsoever without the expressed written consent of Martin LLC. Comments in this handbook are not intended to provide legal advice. Readers should not act or rely on the information contained within this handbook without seeking specific legal advice from Martin LLC.