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Your Employer Is Required to Plan Ahead for Pennsylvania Workers’ Comp Claims

The principle behind workers’ compensation in Pennsylvania is easily stated: workers are guaranteed to receive financial help for their medical bills and lost income after an on-the-job injury or occupational disease, period. In exchange for this guarantee, workers are not allowed to file personal injury lawsuits in Pennsylvania against their employers or coworkers.

The system works well most of the time. When it doesn’t work, the failure happens almost always because employers fail honor the guarantee. They reject a worker’s claim, they try to terminate benefits too soon, or they lie outright to tell the employee he’s not eligible.

Most often, this isn’t a spur-of-the-moment decision to hurt one worker in particular; it’s a sign that the employer long ago made the decision to sacrifice worker safety in favor of profits.

“Workers’ Comp? Nah, We Don’t use That Here.”

Every private-sector employer in Pennsylvania is required by law to make some arrangement to handle workers’ compensation claims. This is absolutely mandatory. A company’s managers have a few options in making these plans:

  • They can purchase insurance. Some insurance companies sell workers’ compensation policies to employers. Under this arrangement, your boss would pay the insurer a premium every three months. The insurer would then pay benefits to any insured worker who files a legitimate claim. The insurance company is betting that, over time, it will collect more money in premiums than it pays in benefits. Your boss chooses this course if he likes the idea of paying regular a premium to protect himself from the risk of a large payout if one person is hurt badly, or if several employees are hurt at once in an industrial accident.
  • They can get insurance from Pennsylvania’s State Workers’ Insurance Fund (SWIF). This works just as we described private insurance in the previous paragraph, except your boss will be dealing with a state agency. SWIF will provide workers’ compensation insurance even for new companies without an extensive financial history; those companies might not be able to find affordable private insurance.
  • They can self-insure. The Pennsylvania Department of Labor and Industry can give a company permission to set aside money to pay workers’ compensation claims directly. But this permission isn’t granted lightly. At a minimum, a company must be able to show regulators that its large, financially healthy enterprise that has been in business for three years or longer.

What Happens if you Have a Claim—but your Boss Hasn’t Bought Insurance?

If the owners of your company fail to make appropriate arrangements to pay workers’ compensation claims, they may be subject to civil and criminal penalties.

But if you’re in this situation, you’re going to be much more interested in what happens to you rather than worrying about whether your boss will be going to jail. Even if your company has failed to honor its legal duty to guarantee your workers’ comp benefits, you still don’t get to sue for personal injury. But you do have a couple of options:

  • You can take your employer to court to demand payment of the comp benefits you are owed. If you win or settle your case, you will receive the money that you deserve, even if the company’s assets have to be sold to pay you.
  • You can apply for benefits from the Uninsured Employer Guaranty Fund. If you are found eligible, this state government fund will pay your benefits and charge the cost back to your employer.

Getting the benefits you need when your employer refuses to play the game fairly is frustrating and infuriating. It’s not a job you can easily tackle alone—and you don’t have to. Schmidt Kramer’s workers’ compensation lawyers in Harrisburg can leverage their years of experience dealing with Pennsylvania law and comp issues to steer your case toward a quick, satisfactory conclusion.

Call us toll-free at (717) 888-8888 if you have a workers’ compensation problem in Dauphin County or any of the surrounding communities. You can schedule a FREE, no-obligation case review and order a free copy of our client handbook, Who Pays The Bills When You Are Injured At Work?