Many people confuse workers’ compensation law with personal injury law. Pennsylvania workers’ compensation law is separate and comes with its own set of complexities, but often these claims result from personal injuries on the job; which leads to this confusion. There are a number of key differences between the two areas of law. Workers’ compensation is a no-fault insurance system, while personal injury often requires someone to be at fault. Here are six of the most common misconceptions surrounding workers’ compensation:

My Employer’s Insurance Company will Take Care of Me

While it is true that insurance exists to cover the cost of your injuries, workers’ compensation insurance is not the same as your personal insurance. The workers’ compensation insurance company works for your employer and themselves, not you. They are a for profit business. Their job is to minimize their expenses and protect their bottom line. To achieve this goal, they will often attempt to avoid responsibility for compensable claims and/or pay out less money than you deserve. An experienced workers’ compensation attorney can help get you the compensation you deserve for your injuries.

I can be Fired for Reporting a Work Injury

It is illegal to fire an employee for reporting a work injury. So while it may happen from time to time, that means the employer is violating the law and may have to face consequences for such an action. In an attempt to avoid this, some employers will claim that the firing was unrelated to the reported injury. By doing so, they are attempting to use the fact that Pennsylvania is an at-will employment state to their advantage. If you believe you have been retaliated against for reporting a work related injury, contact an experienced employment law attorney.

I Cannot be Fired While out on Workers’ Compensation

Some people believe that they can’t be fired while out for a work injury. The Pennsylvania Workers’ Compensation Act provides no job protections. While it is true that your employer cannot fire you in retaliation for filing a workers’ compensation claim, they are generally allowed to replace you with someone who is physically capable of performing the job as Pennsylvania is an at-will employment state. A written employment contract or collective bargaining agreement may provide additional protections not generally available to everyone.

For example, if you are out of work recovering from an injury for eight months, your employer may end up firing you because they need to hire someone new to take your place. If you have been fired, it is important to understand the reason for your termination so that you can determine whether or not it was retaliation. Also keep in mind that there is no guarantee that your employer will have a job for you once your injury has completely healed, even if you have not been formally terminated.

I had a Pre-existing Condition so I am not Covered

Although your employer and their insurance company may claim otherwise, the aggravation of pre-existing conditions is usually covered by workers’ compensation. This is often more difficult to prove than a simple one-time injury. You will have to prove that your condition was in fact worsened due to your new work injury or due to the conditions of your work.

An example of an aggravated pre-existing condition is if you had a bad knee which was made worse due to a workplace fall. The insurance company will argue your knee was already injured, and you will have to prove that the injury is now worse as a direct result of the fall.

I Can Collect Damages for Pain and Suffering

Pain, suffering, and other collateral damages are often a feature of personal injury cases, but not workers’ compensation cases. This goes along with the idea that workers’ compensation is a trade-off. You cannot receive compensation for those collateral damages, but you are supposed to be guaranteed compensation for lost wages and medical expenses regardless of who is at fault in causing your injury, even if it is your own negligence.

I have to Treat with the Company Doctor

You do not have to treat with the company doctor. However, there are reasons for which you may choose to do so. But first, what is a company doctor? A company doctor is one of at least six doctors on a valid company physicians list.

As for why you may want to treat with a company doctor, workers’ compensation only pays for treatment for the first 90 days if it is with an approved doctor — assuming the list is valid and all other procedural requirements are met by the employer. You may choose to see your personal physician within the first 90 days, but the workers’ compensation insurance company may not have to pay the bill or reimburse you if you do. Likewise, you may choose to continue treatment with the company doctor beyond the 90 day period. 

It is important for you to talk with an experienced workers’ compensation attorney before choosing which doctor to treat with. In some cases your employer’s physician may be the better choice, but in others that may not be true. And if you do choose to stick with the company doctor, remember that they are hired by your employer or their insurance company, not you. This doctor may feel the need to make their reports favorable to your employer or to communicate about your condition with a rehabilitation nurse, the adjuster, or some other representative of the employer or insurance company without your knowledge.

Hillsberg Law

Workers’ compensation law is very different from the personal injury law most people are more familiar with, which leads to misconceptions. This is why it is important for you to speak with an experienced workers’ compensation attorney after you have suffered a workplace injury. My name is Geoffrey Hillsberg, and I have solely practiced workers’ compensation law in Pennsylvania since 1995.

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.

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