A guide to some of the most frequently asked questions regarding the Pennsylvania Workers Compensation Act.
1. Do I Need a Lawyer?
A workers' compensation lawyer only gets paid if he gets you benefits (either through settlement or award from a judge) or if he defeats a challenge by the insurance company to cut off or change your benefits. There is a lot that can occur to jeopardize your right to benefits. If you are unrepresented you may not be aware of these things, even as they are occurring. As a result, even if you are already receiving benefits it makes sense to have a lawyer. Your lawyer will advise you how best to protect and maintain your benefits so that you can fully recover and get back to work on your own terms, not the insurance company's terms. There will be no fee unless the insurance company files a petition to cut off or charge your benefits.
2. How Do I Know if I Am Getting the Right Amount of Benefits?
Under the workers' compensation act, you are entitled to two-thirds of your pre-injury average weekly wage. This is subject to both a minimum and a maximum. Your average weekly wage is determined by analyzing your earnings during the year prior to your injury. Often, your employer or the insurance company will miscalculate your average weekly wage and you will be underpaid. An attorney will make sure that your benefits are properly calculated and he will get you the retroactive benefits you are entitled to, plus interest.
3. if I Hire a Lawyer, Won't I Lose 20% of My Benefit Check?
NO! As long as the insurance company doesn't try to stop or reduce your benefits, there is no fee. When you hire an attorney during that time to monitor your case, it costs you nothing. Your attorney will advise you with regard to independent medical examinations and vocational interviews. If your check is late or your bills aren't being paid, your attorney will contact the insurance company on your behalf and make sure that those things are taken care of. The only time you will pay a 20% fee is if your attorney defeats a petition to reduce or cut off your benefits or if the attorney gets you benefits your are not currently receiving, either through settlement or a judge's award.
4. How Long Can I Get Workers' Compensation Benefits?
You can receive total disability benefits for the rest of your life. You can receive partial disability benefits for 500 weeks. You receive partial disability benefits if you return to work and earn less than you did per week before your injury. In addition, once you have received 104 weeks (two years) of total disability benefits, the insurance company can request that an impairment rating examination take place. A doctor selected by the Bureau of Workers Compensation will assess your "impairment rating". If that rating is less than 50%, then you will be deemed "partially disabled" and you will only be entitled to another 500 weeks of benefits. It is important that you have an attorney to advise you during this process so that he can help you avoid being labeled "partially disabled".
5. How Is a Settlement Valued?
Settlements are based on many factors. The extent of the injury, the type of work performed, the age and education of the claimant are some of the factors that go into calculating value. However, the most important factor is the pre-injury average weekly wage. This is the weekly amount of money that the insurance company calculated that you earned prior to your date of injury. If it was improperly calculated this could lead to your case being undervalued for settlement. An important factor that is not part of the calculation is pain and suffering. While workplace injuries are often highly traumatic and place great pressure on the injured worker and his family, the Pennsylvania Workers' Compensation Act does not provide for compensation for pain and suffering.