I can’t tell you how many injured workers come into our office without the proper documentation backing up the legal status of their case. I promise you, it is rarely the fault of the injured worker, but rather the lack of attention by the insurance adjuster to the laws and regulations imposed by the Pennsylvania Workers’ Compensation Act.
Section 406.1 of the Pennsylvania Workers’ Compensation Act requires an employer and its insurance carrier to promptly investigate all reported work place injury claims – “all injury claims” include those injuries large and small. The law imposes upon employers and their insurance companies a duty to file official paperwork with the injured worker and the Bureau of Workers’ Compensation confirming that the injury has either been accepted, denied, or that additional time is needed to complete the investigation. Either way, official documentation must be filed. The documentation must be on a form specifically generated and utilized by the Bureau of Workers’ Compensation. The form must be issued to the injured worker AND the Bureau of Workers’ Compensation and it must be done so within 21 days of the injured worker providing his employer with notice of his on-the-job injury.
The most common legal form used to accept a work injury claim is a “Notice of Compensation Payable.” The Notice of Compensation Payable contains many important pieces of legally significant information including, the contact information for the parties involved in the case, the specific body part injured, the amount of weekly disability benefits to be paid, the frequency with which those payments will issue, and the first date on which cash benefits are set to begin.
The Notice of Compensation Payable tells the injured worker and his employer/insurance carrier where the injury claim stands and right from the outset of the claim. It puts everyone on notice of which benefits will be paid under the claim. It also provides starting point for an injured worker to bring his case before a Workers’ Compensation Judge when he believes that his injury has been described incorrectly or when he believes that he is being paid less money than he is owed.
Regrettably, all too often, insurance companies will begin paying lost wages or medical benefits on an injury case but choose to not file the Notice of Compensation Payable with the injured worker and the Bureau. Without this important documentation the insurance company is then free to take advantage of the injured worker’s circumstances and selectively issue wage loss payments at their own discretion and pay only those medical bills that the insurance carrier finds to be appropriate. Without the Notice of Compensation Payable in hand, the injured worker’s case has not been legally and the insurance company may suddenly stop making payments at any given moment. The Pennsylvania Courts have ruled that the mere payment of medical bills does not equal an acceptance of a work injury claim. Many people who meet with us are under the mistaken assumption that their case is open and accepted just because the insurance company has been paying their medical expenses. This is incorrect and a very risky position to be in for the injured worker.
If you’ve been injured on the job it is important that you get your paperwork in order. If you’re unsure of which documentation is important it is time to consult with a skilled workers’ compensation attorney who can guide you through the claims process. Get your legal papers in order and protect your rights.