PA WC Basics
This State Agency is responsible for administering the Workers' Compensation program in Pennsylvania.
What is the Pennsylvania Department of Labor Bureau of Workers' Compensation?
Number one way to reduce workers' compensation cost and liability.
What is return the employee to gainful employment?
Suspension of Benefits
Preservation of employment relationship
Reduce costs
A worker reports a low back injury on Monday afternoon and the Employer shortly thereafter hears that the injured worker told other employees about falling at a water park on the previous Saturday.
What should the employer do with this information?
Secure a statement(s) from co-worker(s).
Verify facts if possible.
Secure verified statements as needed.
Guidelines for injured employee to follow to preserve rights to benefits under the Workers' Compensation Act.
What is Notice of Rights and Duties.
This type of injury, which occurs over time rather than from a single event is also covered under PA Workers' Compensation.
What is a repetitive stress injury?
In Pennsylvania, these benefits are generally paid to an employee injured in the workplace.
What is Workers' Compensation benefits?
The WC Act provides immediate access to wage replacement and medical benefits.
The injury must be sustained in the course and scope of employment.
A job offer sent to an injured worker must be accompanied with this document.
What is a Notice of Ability to Return to Work?
Also, should include, medical opinion upon which the offer is based and job description.
An injured worker reports physical injuries caused in part by fume exposure or inhalation at the Employer's facility. The Supervisor and Safety Team should take what steps?
Investigate the allegations of fume exposure and compile all reports related to safety at the plant.
Date when the Notice of Rights and Duties must be signed by the employee.
What is date of hire and as contemporaneous as possible to the work injury?
Under PA law, this type of exam, requested by the Employer and their insurance carrier, may be required to determine the status of an injured worker's condition.
What is an Independent Medical Evaluation?
Bureau form used for recognition of work-related injury by employer.
What is NCP, TNCP or Denial?
A temporary notice of compensation payable is the preferable method unless liability is clear.
TNCP gives the employee immediate access to benefits and provides the employer with 90 days to make a final determination.
Physical parameters for return to work?.
What are work-related restrictions?
Employers need to work with employees and their corresponding work restrictions to accommodate an effective return to work.
Employers need to remember competing statutes like ADA and FMLA.
A worker approaches their supervisor and tells the supervisor that their back is sore from work but they don't want to file a claim. The supervisor should take these additional steps.
What is fill out an injury report, report the claim, and document their conversation with the worker?
Result of the employee failing to follow the guidelines of the Notice of Rights and Duties.
What is compromise of rights under the workers' compensation act.
An employee that refuses to follow the guidelines may compromise their rights under the Act. Specifically, and most typically, employees that treat off panel may not have medical benefits paid even in the event of a compensable injury.
Number one protocol for proper evaluation of a workers compensation claim.
What is DOCUMENT EVERYTHING?
The amount of days the employer has to recognize an injury?
What is 21 days?
The employer must accept or deny a claim with the Bureau within 21 days of the date of injury.
Reporting protocols are critical.
Employers must gather as much information about claim as possible in short period of time.
What are attorneys fees and litigation costs?
An employee tells their supervisor that their shoulder is sore and the supervisor sets the employee up for ART Evaluations and Treatments. The supervisor should also do this.
Follow-up with the employee to ask why their shoulder is sore to determine whether the soreness is a result of work activities.
A list of medical providers selected by the employer for initial evaluation and treatment of a work-related injury.
What is a list of approved Panel Providers?
Set of guidelines employees are required to follow upon return to gainful employment.
What are company policy and procedures?
Employees are subject to all of the same rules and regulations provided they are not specifically compromised by injury or accommodations?
Termination for cause may be an affirmative defense to ongoing liability and expense.
Statute of limitations for employee to file a claim for workers' compensation benefits.
What is three (3) years?
However, an employee must provide notice of the work injury as soon as practicable to preserve their rights.
Injuries reported within 20 days are compensable back to date of injury. Injuries reported between 20 and 120 days are compensable from date of report. After 120 days, rights may be forfeited.
When an injured worker returns to work at wages less than they were earning at the time of injury, they are entitled to this type of benefit.
What is partial disability benefits?
after work, a few employees gather around their cars int he parking lot to chat before heading home for the day. after some joking around one employee grabs the favorite cap of another employee and a spirited game of keep away follows. During all the fun, Linda falls and twists her knee requiring medical attention. Is Linda's injury covered by the workers' compensation act?
Injuries that occur int he course and scope of business - the furtherance of the employer's interest are work related.
Injuries that occur on the employer's premises are often considered work related.
With proper policy, injuries resulting from horseplay are not covered by the Workers' Compensation Act.
Consequence to the employer for failure to supply a Notice of Rights and Duties.
What is forfeiture of right to panel provider for first 90 days of treatment?
Controlling the initial evaluation and treatment of an injury is often critical to resolution of a claim.
If employers do not utilize a Notice and/or get it properly executed this right may be forfeited.
Although they do not result in injuries, these types of events should still be documented by supervisors and management.
What are near misses?