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How will your family cope if you are debilitated by a work injury?

As a member of the Pennsylvania workforce, you might be concerned about the welfare of your family should you suffer serious injuries in an on-the-job accident. Even with workers’ compensation insurance coverage, your fears are not without ground because there can be many pitfalls in navigating a benefits claim. Knowing your rights may prepare you for such an event.

The Pennsylvania workers’ compensation program covers any injury, illness or death that was caused by your employment. However, some circumstances may revoke your right to compensation. Any injury or death that a worker intentionally inflicts on him or herself may not be compensable. The same can go for injuries, illness or death that resulted from illegal drug use or alcohol consumption.

What types of benefits are available?

The nature of your occupational illness or workplace injury and the severity of it will determine the benefits for which you will qualify, which can include the following:

  • Lost wages — If your injury or illness prevents you from returning to work within seven days, you will receive compensation that is a percentage of your average weekly wage, which typically equates to approximately two-thirds of your normal income. The duration of the payments will depend on whether your injury caused partial or total disability.
  • Death benefits — If your injury turns out to be fatal, you surviving loved ones will be eligible to claim benefits to cover the costs typically related to end-of-life arrangements, along with a wage-replacement package for a predetermined period.
  • Specific losses — These benefits usually follow injuries that result in amputations. Upon the partial or total loss of a body part, eyesight, hearing or permanent disfigurement of your neck, face or head, you might qualify for specific loss benefits.
  • Medical care — Reasonable charges for health and surgical services related to your injury or illness and provided by physicians or registered health care providers will be paid immediately. Your employer must provide a choice of six approved doctors, and you must go to one of them for initial treatment. However, some rules will allow you to go to your own physician after a predetermined period.

It may help to keep in mind that nothing is ever as simple as it seems. Such is the case with the Pennsylvania workers’ compensation insurance system. You may have questions about when you will receive payment, what happens if you return to a lower paying job and the possibility of a denied or rejected claim.

The most logical step to take if you suffer a workplace injury or develop an occupational illness would be to consult with an experienced workers’ comp attorney — after reporting your injury to your employer. Such a professional can help you throughout the process — from preparing and filing your initial benefits claim through filing appeals if necessary. A lawyer’s representation in negotiations with the insurers can be invaluable, and he or she may even utilize the services of independent experts to help put together a strong claim.

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