Workers' Compensation

What is Workers’ Compensation?

Workers’ compensation is a no-fault benefit system designed to provide assistance to workers disabled by work related injuries. It compensates wage loss suffered by the injured worker and pays for the injured workers medical treatment.

The workers’ compensation system was created around the turn of the century in Pennsylvania in order to address problems that had arisen in the industrial economy. Before the workers’ compensation system was created, injured workers had no “support system.” Workers were required to sue their employers to obtain compensation.

Suing the employer required proof of fault. In those cases where injuries were the result of accidents that were no one’s fault, or were the fault of the worker, the worker had no chance of recovery. Pursuing a lawsuit took time. Pursuing a lawsuit took money. Workers who were injured and not working could not afford either the time or the money required to pursue the suit. Those that did pursue claims were met with substantial legal defenses by their employers. In the meantime, living expenses went unpaid and needed medical treatment could not be paid for.

In order to meet an injured worker’s living expenses and pay for his medical care, the legislature created the workers’ compensation system, an idea imported from Germany. The system changed the old rules by requiring the employer to give up its powerful defenses. The employer was required to pay for basic needs, wage loss benefits and medical expenses, whether the injury was the employer’s fault or not.

In exchange for expanding the employer’s liability for claims to those where it was not at fault, compensation was limited to the basic needs of the worker – wage loss benefits and medical expenses. The employer was given immunity from the other compensation that used to be pursued in the lawsuits they so successfully defended. As a result, the workers compensation system does not compensate for pain and suffering.

Do I Need a Lawyer?

The system was originally designed to be a system that was procedurally easy, one that an injured worker could navigate on his own without a lawyer. But the employers and their insurance companies had lawyers. Soon the process became complicated to the point where it is not advisable for an injured worker to represent himself.

You need a lawyer so that you know “the rules of the game.” Only criminal law and family law result in more reported appellate decisions. Appellate decisions are where laws get “made.” The workers compensation law in Pennsylvania is constantly evolving. You need a lawyer to stay on top of this complicated and fast changing area of the law.

What Can a Lawyer Do for Me?
  • Get you paid – If your employer or its insurance company has denied your claim for workers compensation, you need a lawyer to take them to court and get you paid. A workers’ compensation lawyer files the necessary paperwork and arranges the introduction of the necessary evidence to the workers’ compensation judge so that you can win your case.

  • Get you paid the right amount – Even if you are getting paid, you may not be getting paid the right amount. Your weekly compensation rate is determined by your average weekly wage. There are many different rules that apply to the calculation of your average weekly wage. The insurance companies do not always consider all the appropriate rules. Applying a different rule might increase your compensation. A workers’ compensation lawyer will help you decide whether you need to check those calculations and will make sure you are getting paid the right amount.

  • Get you good medical care – Most workers and doctors believe they have to treat with the company doctor for 90 days after the injury. The law provides that the worker must treat with the company doctor for 90 days only when the employer does certain things to enforce that obligation. Many employers do not do all the things necessary to create that obligation but they tell their employees that the obligation exists. Would you rather be seeing your own doctor rather than the company doctor? Even if you must treat with the company doctor, your employer must give you choices. Your employer can not force you to treat with one specific doctor or clinic. A workers’ compensation lawyer will help you determine whether you really have to see the company doctor or whether you can go to a doctor of your choice.

  • Answer your questions – Workers’ compensation is complicated. You will receive lots of free advice from well-meaning friends. But your employer and its insurance company have lawyers, claims adjusters, human resources specialists, and doctors who are trained to use the laws in the way that benefits them. They will tell you what they want you to know. They are interested in the bottom line, not your future. They are trying to make the system work for them. Wouldn’t it be wise to have your own coach, who knows the rules of the game, to advise you about your rights, your responsibilities, your choices, and your future? A workers’ compensation lawyer will advise you, educate you, and coach you so that you have the power to make your own decisions and can make the system work for you.

  • Protect your future – If your injury is so serious that you are not likely to be able to return to your old job after you are treated, you need a lawyer. You will be facing lots of questions about your claim. Your employer’s insurance company targets these types of claims for the most aggressive treatment. These types of claims cost them the most money. They devote the most resources they can to reducing those costs. The law does not provide for mandatory rehabilitation services. The insurance company is not interested in how you are going to make a living in the future. It is only interested in controlling its costs. A workers’ compensation lawyer will help you plan for the future, guide you to resources outside the workers’ compensation system to get assistance with your plan, and help you use the workers’ compensation system to achieve your goals.

How Much Will a Lawyer Cost Me?

Possibly nothing. That’s right, possibly nothing. In most cases, workers’ compensation lawyers are paid a contingent fee, a percentage of your benefits (usually 20%) that must be approved by a workers’ compensation judge. Until a workers’ compensation judge approves your lawyers’ fee, you do not have to pay your lawyer. If your workers’ compensation lawyer is able to help you with some education and advice and your case never winds up in court, you pay nothing. If your case goes to court because of a dispute or to get a settlement approved, then you will pay the contingent fee only after the judge approves it. The work your lawyer has done on your case before the approval is almost always free. The lawyers at Warren & McGraw have gladly given out lots of free advice to injured workers over the years. Why not take advantage?

See more Workers Compensation FAQs