The Workers Compensation Claim Process- From Start To Finish

Date: January 11, 2007

If you are injured while working in Pennsylvania, you will be faced with many questions. How do I report my injury? When must the injury be reported? How long do I have to file a claim? How do I file a claim? The procedural rules are daunting and entire process can be very intimidating.

I have set forth a brief overview as to the procedures that are followed in a workers’ compensation case from the reporting of a work injury, through the litigation of the claim, and the filing of any appeals.
Employers in Pennsylvania are required by law to post a pre-printed “Notice of Injury” form in a conspicuous location within the workplace regarding the reporting of work injuries. This form specifically states: “Remember: It is important to tell your employer about your injury”. This posted form also should inform employees as to the name, address and telephone number of the employer’s workers’ compensation insurance carrier or internal workers’ compensation contact person.

An injured worker in Pennsylvania is referred to as a “claimant”. A claimant has 120 days from the date of injury to report the injury to the employer. Compensation may be disallowed if the injury is not reported:(1) within 120 days from date of injury or (2) within 120 days from the date when the claimant has knowledge of a work-related disease.

Employers are required to immediately report all employee injuries to their insurer or, if self-insured, to report them to the person responsible for management of the employer’s workers’ compensation program. If an injury results in the death of the claimant, the employer is also required to file with the Workers’ Compensation Bureau a report of injury within 48 hours of the injury. If the injury does not result in death but does result in the claimant being disabled for more than one day, the employer must report the injury to the Bureau after seven days and within 15 days after the date of injury.

Within 21 days from the date the claimant provides notification of an injury, the employer/insurance carrier shall either: (1) accept liability for the injury and issues a Notice of Compensation Payable or a Notice of Temporary Compensation Payable or (2) deny liability and issue a Notice of Workers’ Compensation Denial to the employee.

If the employer/insurance carrier denies liability, the claimant has three years from the date of injury to file a Claim Petition. A Claim Petition is a formal filing with the Bureau requesting acknowledgment of a work-related injury and the payment of benefits.

After the Claim Petition is filed, the case is assigned to a Workers’ Compensation Judge (WCJ) by the Bureau. Assignments are generally made to a WCJ who hears cases in the county where the claimant lives.
Once the case is assigned, all parties involved in the case will receive written notice of the date, time and place of a hearing.

The WCJ will hear evidence presented by both the defendant (employer/insurer) and claimant at one or more hearings. Generally, both parties will also present deposition testimony of medical witnesses. Claimant will typically present medical testimony from a physician or medical specialist who has evaluated and treated the claimant. The defendant is entitled to have the claimant examined by a physician of their own choosing.
Most recently, the Pennsylvania Workers’ Compensation Act was amended to require mandatory mediation in all newly filed workers’ compensation cases. These mediations are to be held before a WCJ.

After a claim petion is litigated, the WCJ will close the evidentiary record. The parties will submit written briefs or other legal memoranda setting forth their respective positions. The WCJ will then issue a formal written decision.

Once the WCJ issues a decision, either party has 20 days from the date the decision is circulated to file an appeal with the Workers’ Compensation Appeal Board (WCAB). The WCAB will conduct an appeal hearing at which time the parties will present oral argument and submit written briefs. The WCAB will then issue a written decision. Either party has 30 days from the date of circulation of the WCAB’s decision to file an appeal with the Commonwealth Court. The Commonwealth Court will conduct oral argument, receive written briefs from the parties, and then issue a written decision. Either party has 30 days from the date of circulation of the Commonwealth Court’s decision to file a Petition for Allowance of an Appeal with the Pennsylvania Supreme Court.

If you are injured while at work, contact me and I’ll be happy to assist you in securing benefits. I can be reached via telephone (570) 347-1011 or via email at tcummings@dlplaw.com

Thomas P. Cummings, Esq.

Joe Price
Attorney Joe Price is a seasoned Trial Lawyer serving Northeast, Central and Southeast Pennsylvania for the past forty (40) years. He has handled serious personal injury cases in courts throughout the Federal system including New Jersey and New York. Attorney Price is A.V. Rated by Martindale Hubble. He is Board Certified in Civil Practice by the National Board of Trial Advocacy since 1996.