There is often confusion over what workers’ compensation benefits actually encompass. In Pennsylvania, workers’ comp benefits include two primary things: Medical Treatment and Lost Wages.
Unlike an auto accident case, you can’t recover for pain and suffering, or collateral damages, loss of consortium or those types of financial losses. You can only recover your medical bills and your wage loss benefits. There are some rare occasions where if the insurance company violates the act you can get penalties awarded on top of that, but that isn’t as common.
What do work injury medical benefits include?
Medical benefits are generally paid directly to providers. The provider is required to, in a timely fashion, notify the carrier they are treating you. The provider is required to submit their bill on a proper insurance form with supporting medical documentation showing that the treatment in question is related to the work injury. After it’s been properly submitted to the insurance company or the employer, they have 30 days to process and pay the bill or to properly refute the bill.
What do workers comp wage loss benefits include?
The other side of the benefits would be the wage loss benefits. Those are checks that are paid directly to the claimant, from the insurance company or employer. The amounts vary widely based on cases, based on the pre-injury average weekly wage.
The advice offered above is general in nature and may not be applicable to every case. Consultation with an attorney is highly recommended. Reliance on this advice does not represent the formation of an attorney-client relationship in the absence of a fee agreement with Mr. Hillsberg.