There are many different deadlines in the workers’ compensation system. Missing some deadlines may have minor consequences, while others may result in the denial of the claim entirely. Some deadlines apply to the injured worker, while others apply to the employer or insurance company. Some apply to the medical treatment providers. Any of these deadlines – missed by anyone – could affect your rights.
As just a few examples of the most common issues:
NOTICE OF INJURY: The injured worker must notify the employer of the injury within 21 days of the incident. Notice must be provided to someone in a supervisory/management capacity – not just a co-worker. If you miss the first deadline, there is a second deadline of 120 days. If an incident is reported between 21 – 120 days, no benefits are due before the date Notice was given; but may be awarded as of the date of Notice. After 120 days, the claim may be entirely prohibited. Even if a claim is reported within the deadlines, the longer you wait to report an injury, the more likely your claim may be denied, because the employer or insurance company may doubt anything relay happened at work. If your case goes before a Workers Compensation Judge, that judge may also have doubts about whether the injury occurred at work.
FILING A CLAIM: The deadline to file a Petition for workers’ compensation benefits is three years from the date of incident. If an injury is caused by ‘repetitive activity’, the date starts to run from the last date the activity is performed. As above, the longer you wait to file a Claim, the more likely the employer, insurance company or even the Judge may doubt your story.
COMPANY DOCTOR: If the employer has a valid Company Doctor List, the injured worker must treat with that doctor for the first 90 days after the injury – with several exceptions. The duty is on the employer for the list to be valid, and the many exceptions which allow the injured worker to see their own doctor are numerous. Contact a Workers’ Compensation Specialist Lawyer to learn all the details.
DURATION OF BENEFITS: If an injured worker is legally defined (not by medical definition, or even common sense – but the legal definition) as ‘totally disabled’, workers’ compensation can – in theory – last for life. If the claimant is legally defined as partially disabled, wage loss can last a maximum of 500 weeks. Medical benefits may continue beyond that deadline. The insurance company has many tricks and tactics to classify an injured worker as only partially disabled, and to reduce the duration of benefits even lower than 500 weeks.
ACCEPTING OR DENYING CLAIM: The insurance company has 21 days after the report of a work injury to accept or deny the claim, by issuing specific forms with the Bureau of Workers’ Compensation, with a copy to the claimant. Their failure to timely accept or deny claim may entitle the claimant to an award of penalties, and/or have the judge Order the insurance company to pay your lawyer’s fee.
TEMPORARY COMPENSATION: The insurance company can decide to accept a claim on a ‘temporary’ basis while they complete their investigation. Within the first 90 days after the incident they must formally accept or deny the claim, as above. Failure to file then proper forms timely can result in an award of penalties or lawyer fees.
APPEAL: When a case is fully fought before a Workers’ Compensation Judge (WCJ) to a final decision, one (or sometimes both) parties may file an appeal. The deadline to file an Appeal from the WCJ’s decision to the Workers’ Compensation Appeal Board (WCAB) is 20 days. An appeal may take on average 8-9 months to be decided. A further appeal to the Commonwealth Court may be filed within 30 days of the WCAB’s decision. A final level of appeal may be taken only with ‘permission’ of the Supreme Court of Pennsylvania. That court picks and chooses which cases they will accept. A Petition for Allowance of Appeal must be filed within 30 days of the Commonwealth Court’s Decision. In between each level of appeal, either party may also file a Petition for Rehearing or Reargument before any given Court or Judge – on limited bases.