Protect your rights and talk to a workers' compensation lawyer.
If you’ve been hurt on the job, your priority should be getting the medical attention you need to put yourself in the best position to recover. In most cases, healthcare treatments and procedures should be taken care of right away.
We understand it can be frustrating when you have to wait due to delays involving your workers' compensation claim. Instead of getting the help you need, you end up in limbo, waiting for approval from your employer's workers' compensation insurance company.
But can they do this? What are your rights? And what options are available to you? Each state has its own unique workers' compensation system. Let’s review how workers' compensation insurance works in Pennsylvania and what you can do if you're not receiving the medical care you need and deserve.
What are common causes of delays involving workers' comp medical care?
There are many reasons why medical care might be delayed for sick or injured workers who filed a workers' compensation claim with their employer, including the following:
- The employer's insurance company claims they need more time to process the request or investigate the injury or illness.
- The employer's insurance company claims there is not enough evidence in support of the claim to approve it.
- The wrong forms were submitted, or there were mistakes on the workers' compensation application.
- There was a miscommunication between the employer and the workers' compensation insurance company.
- There is a dispute over which doctors or medical professionals should provide your care.
"There's no excuse for delaying vital medical care for sick or injured workers," says O'Malley & Langan attorney Mary Anne O. Lucas. "If you're not provided access to the medical care and support you need, you deserve answers and immediate action. Your health should always come first."
How much time do employers have to process workers' comp claims?
In Pennsylvania, injured workers have 120 days to notify their employer of a work-related injury or illness. Once an employee provides notice, employers have 21 days to approve or deny a workers' compensation claim, according to the Pennsylvania Department of Labor and Industry.
If an employer needs more than 21 days to process a workers' compensation claim, the company must issue a Notice of Temporary Compensation Payable (LIBC-501) to extend their investigation to 90 days. Employers must submit this form to the Pennsylvania Bureau of Workers' Compensation, along with a Statement of Wages (SOW).
A Statement of Wages lists the gross income (pre-tax earnings) someone was making before their work-related injury or illness. It also details the amount of money the employer's workers' compensation provider is supposed to pay the employee if the workers' compensation claim is approved.
What are my options if workers' comp is delaying my medical care?
If you don’t receive timely medical care after filing for workers' compensation, you have options:
- Contact your employer and express your concerns verbally, in front of a witness, or in writing.
- Write a letter or send an email to your employer's workers' compensation insurance company and ask them to provide you with an explanation for the delay. Always keep a copy of correspondence to and from your employer and the insurance company.
- Contact the Pennsylvania Department of Labor and Industry at 1-800-482-2383.
- File a Claim Petition with the state Bureau of Workers' Compensation.
- Contact an experienced Pennsylvania workers' compensation attorney, like O’Malley & Langan, right away.
"Usually, the best way to get the medical care and workers' compensation benefits you deserve is to have an experienced lawyer handling your case every step of the way," says retired workers' compensation judge and O'Malley & Langan attorney Joseph Grady.
How can a workers' compensation lawyer help?
While you can try to demand the medical care you deserve from your employer or their insurance company, dealing with complex legal issues can be challenging, especially if you're sick or seriously injured. This is why many people seek the help and guidance of an experienced Pennsylvania workers' compensation attorney.
"You have enough to worry about if you got hurt or became sick at work," says O'Malley & Langan Founder and Senior Partner Todd J. O'Malley. "Our job is to help you obtain proper medical care and financial support. You have the right to receive workers' compensation if you sustained a work-related injury or illness. That's the law in Pennsylvania. And we will do everything we can to get you the benefits you need as quickly as possible."
Learn more about your legal options. If you're not receiving the medical care you need to treat a work-related injury or illness, contact our Northeastern Pennsylvania law firm for a free, confidential, no obligation consultation.