In Pennsylvania, like most states, workers' compensation is a must. This means employers and independent contractors must purchase this insurance for their employees or risk facing fines, imprisonment, and civil liability.
That said, there's plenty of misinformation on workers' comp, causing widespread confusion. Today, we separate concrete facts from prevailing myths so your business can stay on the right side of the law. Here are the most common facts and misconceptions about workers' compensation in Pennsylvania.
The following worker's comp assertions are accurate:
Under Pennsylvania law, workers' compensation is no-fault insurance. The no-fault system means the law doesn't consider liability when awarding settlement for workers' comp insurance. Employees will get compensated for their injuries or illnesses regardless of their fault. This system not only simplifies the claims process but also guarantees employees compensation.
Certain job positions are exempt from workers' compensation coverage. This exemption is usually because of the nature of their work, legal classification, and other factors. Workers exempt from this insurance include:
Employees must decide whether to file a workers' comp claim or lawsuit against their employers. The former is less stressful and is almost guaranteed, while the latter has a higher award potential.
Filing a lawsuit is the better option if your employer flouted labor laws and put your health in jeopardy. For instance, if the employer overtly disregarded state-mandated OSHA requirements and regulations. On the other hand, a workers' comp claim is more straightforward, and benefits are almost certain.
While occupational accident insurance (OAI) and workers' compensation insurance are almost similar, neither substitutes the other. Remember, workers' comp insurance is mandatory by law, while OAI is not. The state will hold employers liable for offering OAI instead of workers' compensation insurance from recognized insurers.
It's not uncommon for employers to opt for OAI since it's cheaper and has fewer legal obligations than worker's comp. However, it has lower coverage limits. Most employers also offer them to employees who don't qualify for workers' comp insurance. The only upside to OAI is that it covers pain and suffering, unlike workers' comp insurance.
Employees may feel hesitant to return to work too quickly, concerned that doing so might jeopardize their access to ongoing benefits during their recovery. However, you're still entitled to your rightful benefits under specific circumstances. For instance, let's say you're only partially recovered and can work half-shifts at best. Your parker's compensation insurance will cover your remaining shift as lost wages.
Another example is if, per the doctor's recommendations, an employee can only perform light duties until complete recovery. Usually, light-duty work attracts lesser wages. Workers' comp benefits will make up for the reduced wages in such cases.
Below are some common misconceptions about workers' compensation insurance that could mislead you:
Unscrupulous employers may dupe workers into thinking that workers' comp insurance is an extra benefit for high-performing employees. This may be a ploy to create a false sense of privilege or "encourage" proactiveness.
Workers' comp insurance is far from a privilege but is a requirement under Chapter 121 of the Pennsylvania Statutes. Withholding workers' comp benefits from employees for underperformance or whatever reason is illegal.
Workers' compensation also applies to injuries outside employees' permanent places of employment. Workers' comp still covers employees outside the premises on off-site locations, provided the injury occurred during regular work hours. However, this doesn't mean that it will cover injuries workers get during their daily commute. Still, it will cover injuries incurred during company retreats and work-related travel.
Contrary to popular belief, workers' compensation claims have "expiry dates." For starters, workers have 120 days to notify their employers about their injuries or illnesses for their claim to sail through. They must also file their claim no more than three years from the date of the injury for the claim to be valid. Any claim filed over three years past their injury or sickness date is null and void. Three years is enough time for workers to identify latent injuries that take weeks or even months to develop.
Workers' compensation is an insurance policy guaranteed by Pennsylvania's legal system. The law prohibits employers from firing employees who file workers' comp claims following work-related injuries or illnesses. Employees can sue their employers for firing them after filing their claims in a wrongful termination lawsuit.
Workers in Pennsylvania forfeit their right to sue their employer for pain and suffering and other non-economic damages under the Workers' Compensation Act. The only way employees can receive these benefits is if they file a lawsuit against their employers and forgo their claims.
Lawsuits aren't as straightforward as workers' comp claims. Workers must prove liability, which involves providing evidence that the employer:
Private insurance companies, rather than the state, pay workers' compensation benefits. Employers can only get workers' comp from a licensed insurance provider or the State Workers' Insurance Fund. That said, employees can only file legal complaints against their employers but can't make inquiries about benefits or coverage from the state.
Workers' compensation can be complicated for both employers and employers. The next time you're filing (employee) or processing (employer) a claim, at least you'll have your facts in check. Remember, workers' compensation insurance is a must, except for a handful of occupations.
You can also contact the Pennsylvania Department of Labor & Industry should you have any issues or complaints with your workers' compensation insurance. You may also need to seek legal counsel if you'd rather sue your employer than file a claim.
