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Pennsylvania Work Accidents & Medical Bills – How Your Medical Bills Get Paid (Part 1)

For most workers and employees, a work accident is about the furthest thing from their minds. However, knowing what to do in the event of a work accident can prevent a tremendous amount of stress. This is especially true when it comes to getting medical treatment covered and getting medical bills paid.

Pennsylvania workers who are injured while on the job can obtain medical treatment or otherwise get their medical bills paid in two ways: workers’ compensation and/or a tort lawsuit. Part 1 of this article will discuss getting medical treatment/bills through a workers’ compensation claim. Part 2 of this article will discuss getting financial compensation for medical bills via tort lawsuits.

Workers’ Compensation Claims for Medical Treatment

Under Pennsylvania workers’ compensation laws, the vast majority of employers are required to provide workers’ compensation benefits for work related accidents and injuries. This applies even if an accident was the worker’s own fault. The typical example involves a worker who trips over their own feet and falls while at work. The accident and injuries would be covered by workers’ compensation unless otherwise exempted due to factors such as the employee’s alcohol or illegal drug use at the time of the accident.

Workers make claims directly with their employers, and in many cases, their employers’ workers’ compensation insurance companies. The reality is that workers’ compensation works much like auto or homeowner’s insurance. Employers pay premiums for workers’ compensation insurance, and when a claim is made, the insurance carrier handles it. This includes claims for medical treatment and in cases of disability, indemnity payments, or payments for lost wages.

One thing most injured workers don’t know is that they are initially required to treat with medical providers chosen by their employers/workers’ comp insurance companies for the first 90 days of medical treatment. However, the worker may choose to see any doctor on the list of employer approved medical providers. So, for example, if the first doctor is unsatisfactory, the injured worker can see another provider on the list. If after 90 days, an injured worker chooses to see their own doctor, notice must be provided to the employer within 5 days; otherwise the claim may be denied.

Related: Are Fatal Work Injuries in the U.S. Down?

Time Limitation to Make a Workers’ Comp Claim in PA

There is a time limitation which applies to workers’ compensation claims in PA. Too often, cases are defended by insurance companies on the grounds that the incident or injury was not timely and properly reported. If you’re injured in a work accident, you are required to provide notice to your employer within 21 days of the work accident.

If you missed the 21 day deadline, notice must be provided no later than 120 days of the injury. Failing to do so is likely to result in denial of your claim. However, in some instances, an exception to the 120 day rule may allow you to notify the employer beyond the 120 days. The so called “discovery rule” exception provides that the time for giving notice of an injury does not begin to run until you know of or should reasonably know of the injury and its relationship to the employment. This discovery rule usually applies in cases of diseases or injuries which develop over a long period of time, or cases where the employee wouldn’t necessarily know off the bat that the injuries are related to work.

Pennsylvania Work Accident & Injury Law Firm

Laffey, Bucci & Kent is a Philadelphia based law firm with offices throughout PA and NJ. Our lawyers specialize in work accident injury cases. Please call the firm for more information. Click To Call

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