- Report the Accident: In Pennsylvania, an employee is provided 120 days to notify his or her employer about a work accident that causes either an injury or sickness/illness. There is an exceptions to this strict 120 day rule and it is based on when the employee first discovers the injury or illness (if it's not immediately detectable), known as the "Discovery Rule". Therefore, if an employee develops a medical condition due to his or her workplace environment but doesn't show any symptoms for weeks, months, or even years, that employee may still be eligible to receive workers' compensation benefits BUT will be held to the same 120 day window to notify his or her employer from the date the employee first discovered the issue. Failure to notify the employer within 120 days of a work-related injury or illness will likely mean that the employer does not need to pay the employee's workers' compensation benefits.
- Ensure Your Employer Filed a "First Report of Occupational Injury" Form: In addition to doing your part as an employee by notifying your employer of your injury or illness, an injured or sick employee should also confirm that his or her employer has filed with its insurance company and the Bureau of Workers' Compensation what is known as the "First Report of Occupational Injury" form. The insurance carrier is then provided twenty-one (21) days to make a determination on the claim. This means the carrier has 21 days to either accept the employee's work injury claim, meaning the carrier will cover medical treatment and lost wages, or the carrier can deny the claim.
- Promptly Schedule an Appointment with a Workers' Compensation Doctor Approved by Your Employer: If an employer posts a list of approved workers' compensation doctors, an employee must see one of those doctors for treatment throughout the first ninety (90) days of their injury or illness. The sooner an employee can get in to the doctor's office, the better. What happens if an employee decides to seek out his or her own doctor instead of one listed by their employer? The result is that the employer, through its insurance carrier, is not required to pay any medical bills until after the first 90 days of the employee's injury. An employee should be sure to verify whether or not its employer has a list of approved doctors. If there is no list posted, an injured or ill employee can see a doctor of his or her own choosing from the start without risking losing coverage for medical bills during the first 90 days of the injury or sickness.
- Receive Employer's Decision and Determine Next Steps: An employer can either accept or deny responsibility for an employee's injury. If an employer accepts responsibility, the employee receives a "Notice of Compensation Payable". If denied, the employee receives a "Notice of Compensation Denial". If an employee feels he or she has been wrongfully denied coverage, the next step is to file a Claim Petition for Workers' Compensation. Employees should be aware that there is a timeline for filing this petition, which is 3 years from the date the employee was injured or made sick at work. It is important to note that it is NOT 3 years from the date of the employer's decision.
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