A Guide to Your Rights

• An Overview and Introduction
• Health Insurance
• Patient Safety
• Private Benefits:
  Motor Vehicle Insurance
• Private Benefits: Disability Insurance
• Private Benefits: Workers Compensation
• Public Benefits:
  Commonwealth Of Pennsylvania
• Public Benefits:
  Crime Victims Compensation Fund
• Public Benefits:
  Federal Government
• Public Benefits: Attendant Care
• Disabled Children
• Rehabilitation Hospitals
  & Facilities
• Vocational Rehabilitation Services
• Civil Litigation: Claims For Damages
• Resources
• Support Groups
• Entitlements And Benefits
• Acknowledgements

 

Private Benefits: Workers Compensation

In Pennsylvania, as in most states, employers must provide workers compensation for work-related injuries sustained by their employees. Workers compensation provides benefits for medical expenses as well as for wage loss (sometimes called indemnity). These benefits are available for work-related injuries regardless of fault – in other words, they are available even if an employer claims that the injury was a result of the ’s, or another worker’s, negligence.

Most employers provide these benefits through the purchase of workers compensation insurance. Employers are required by law to provide these benefits, and workers compensation will almost always be a primary source of medical and wage loss benefits in a work-related injury.

In Pennsylvania, workers compensation pays for reasonable and necessary medical care, and the workers compensation carrier essentially retains control over the medical care provided for the first 90 days after injury. Under many circumstances, an employee is limited to receiving treatment from certain enumerated physicians and, as with many types of “managed care” scenarios, this puts a significant amount of control over the injured worker’s medical care in the hands of the workers compensation carrier.

The availability and extent of workers compensation benefits is governed by statute. There is an extensive and complicated body of law governing the procedural and substantive legal rights of injured workers and their employers/insurance carriers. There is a state agency in Pennsylvania whose sole purpose is to resolve disputes that arise between an injured worker and his employer/insurance carrier. The injured worker’s legal rights are seriously circumscribed by statute and case law decisions. Often an attorney advocate is necessary to protect the injured worker’s rights.

You should check insurance policies to see whether any of these coverages are available.