Pennsylvania workers who are injured in accidents at work often want to know whether they are eligible to make workers’ compensation benefits claims. Below are three issues which determine whether an injured worker can make a workers’ compensation benefits claim.
1. Did the accident or injury happen during the course and scope of employment?
This is a very important first step in determining whether an accident is even covered by workers’ compensation insurance. Under Section 301(c)(1) of the PA Workers’ Compensation Act, “course and scope of employment” is defined as follows:
“injuries sustained while the employe is actually engaged in the furtherance of the business or affairs of the employer, whether upon the employer’s premises or elsewhere, and shall include all injuries caused by the condition of the premises or by the operation of the employer’s business or affairs thereon, sustained by the employe, who, though not so engaged, is injured upon the premises occupied by or under the control of the employer, or upon which the employer’s business or affairs are being carried on, the employe’s presence thereon being required by the nature of his employment.”
Therefore, in general, most accidents which occur on the employer’s work premises will be covered by workers’ compensation. For example, an office worker falls down a flight of stairs or slips in the bathroom at the place of employment. These are classic examples of work related accidents. The employee-worker is literally injured at work. Therefore, the injuries and any resulting wage loss would be covered by workers’ compensation.
2. Does the employer have a valid workers’ compensation insurance plan?
In general, employers in Pennsylvania are required to obtain workers’ compensation coverage. This applies to small and large businesses alike. Even businesses which employ only one worker, part-time or full-time, are required to carry workers’ compensation coverage. Employers may purchase private insurance policies, obtain self-insurance or get insurance from the Pennsylvania State Workers’ Insurance Fund.
However, in some cases, especially for small businesses, employers may fail to obtain any workers’ compensation insurance coverage. If there is no applicable insurance, the injured worker may be able to file a negligence claim against the employer and/or file a claim with the Uninsured Employers Guaranty Fund. This is a special fund available for workers whose employers failed to obtain workers’ compensation insurance. Click here for more information about the Uninsured Employers Guaranty Fund.
3. Was the employer notified of the claim in a timely manner?
Employers must be notified of the accident or injury. Failure to properly notify the employer may result in a denial of the claim. Under the Pennsylvania Workers’ Compensation Act, the initial deadline is 21 days. Injured workers have a duty to provide notice to employers within 21 days of the date of the accident.
However, there is a second deadline – 120 days. This is a mandatory deadline. If a worker fails to notify the employer of the accident within 120 days, the worker may be barred from being able to file a claim altogether. See Section 311 of the PA Workers’ Compensation Act.
It is important to note that determining whether an employer was properly notified often requires advice of a work injury lawyer who is familiar with the PA workers’ compensation claims notice deadlines.
Related PA workers’ compensation legal articles:
- Pennsylvania Workers’ Compensation Law – The Basics (Part B)
- Pennsylvania Workers’ Compensation Law – The Basics (Part A)
Pennsylvania Workers’ Compensation & Accident Lawyer
The Philadelphia law firm of Laffey, Bucci & Kent represents workers who are injured on the job. Our work accident lawyers specialize in handling negligence cases against third parties and may handle workers’ compensation cases. Depending on the facts of a given work accident case, the firm may refer the workers’ compensation case to another law firm. Please call the firm for a free consultation. Click To Call
Jeff Laffey is passionate about workers’ rights and accident safety. Learn about his 2012 workplace safety presentation to union members in Philadelphia.
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