How is your workers’ compensation claim approved?

Pittsburgh is still very much an industrial-manufacturing town. Workers operate in very dangerous environments handling chemicals, large machinery and dangerous processes. This makes Pittsburgh one of the more dangerous cities to work in, for some. Luckily, Pennsylvania has a robust system to protect and provide for injured workers. This post will go over the review and approval process for your claim.

Your employer must provide notice of your rights. This is typically accomplished by putting up a poster that lists your rights, obligations and contact information in case you are injured. If you are injured, you have 21 days to report it to the employer. You do have up to 120 days to report the injury if medical issues or some other problem prevents you; however, you if you take longer than 120 days, your claim may be barred.

Employers must report all employee injuries as soon as possible to their workers’ compensation insurance carrier. Your employer will file a First Report of Injury with the state bureau within seven days of learning of your injury (or 48 hours if the injury results in your death).

At this point, one of three things can occur. The insurance company has 21 days to approve, deny or request an extension to investigator your claim. If your claim is denied, you may seek help from legal counsel to pursue a claim through the courts. If the insurer needs more time, they can file an extension for up to 90 days for further investigations. If your claim is approved, then your claim is sent to the state bureau with an attached wage statement.

Once your claim is approved, your employer provides the wage statement. When you return to work, the insurer may file a notice to suspend your workers’ compensation payments. If the insurer is suspending your benefits it must file a final statement of compensation and a final receipt form with the state bureau.

If you were injured while at work, then you may want to consult with a workers’ compensation lawyer. As you can see, the review and approval process is very complicated. Errors in any one of those steps could delay or even jeopardize your claim.

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