- The most important thing for employees to know is that any time you are injured on the job, you should report the injury immediately to a supervisor (within 21 days of the injury, timeline varies from state to state), in writing if possible. If not reported within 120 days from the date of injury or having knowledge of a work-related disease, no compensation is allowed except for cases involving progressive diseases.
- Within 21 days from notice the employer can take one of four actions:
- The employer can issue a Notice of Denial of the claim. If the claim is denied the injured worker needs to contact an attorney to see whether a claim petition can be filed.
- The employer can issue a Temporary Compensation Payable. This allows the employer to extend the investigation period up to 90 days before accepting or denying full liability for the claim. Within 90 days the employer must issue a Notice of Compensation Denial, Notice of Compensation Payable or Agreement for Compensation.
- The employer can allow the claim for medical only.
- The employer can accept the claim for compensation and medical pursuant to an Agreement for Compensation.
- Once the injured worker receives compensation benefits and the employer accepts the claim, the employer cannot stop benefits as long as a doctor supports the disability.
- If a doctor releases the injured worker back to work on full or light duty, the injured worker must go back to work if said work is available. The employer also has the right to send the injured worker to an independent medical exam (IME) to check the progress of the worker’s disability and to evaluate whether there has been a full recovery. If the IME reports that the worker has restrictions or has fully recovered, the employer can terminate benefits by filing a Termination Petition in court. At that time the matter will be heard by a Workers’ Compensation Judge.
Workers’ compensation claims can be complicated and confusing. Consider consulting with Metzger Wickersham if your employer sends you for an independent medical exam.