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Lehighton Estate, Family & Workers’ Comp Lawyer > Blog > Workers Compensation > Do I Qualify For Workers’ Comp Benefits In Pennsylvania?

Do I Qualify For Workers’ Comp Benefits In Pennsylvania?


When you are injured in a workplace accident, your first priorities are getting proper medical treatment and alleviating the pain. However, you will eventually need to consider your rights under Pennsylvania’s workers’ compensation laws. As you might be aware, employees have legal remedies through the workers’ comp system when injured in a workplace accident. The laws also cover workers who develop occupational diseases because of on-the-job conditions. An important point to note is that you do not need to prove that your employer was at fault to obtain benefits.

However, you do need to show that you qualify for workers’ comp under rules set by the Pennsylvania Bureau of Workers’ Compensation. Most employees will be eligible, but an insurance company might still deny your claim on the grounds that you are disqualified. A Lehighton workers’ comp lawyer can provide specifics on the criteria, but some general requirements include:

 Nature of Employment: A basic requirement is that you must be a true employee instead of an independent contractor, but there can be thorny issues with misclassification. Your employer might try to treat you as a contractor to avoid paying workers’ comp insurance, but it is the nature of the work relationship and arrangement that makes someone an employee.

 Circumstances of the Injuries: Workers’ comp only applies to medical conditions that result from an accident, job-related hazards, or other conditions in the workplace. If you were at your work location and performing tasks for your employer, you will typically meet this requirement. However, there can be challenges with:

  • Occupational diseases, which you must somehow link to workplace conditions or hazards; and,
  • Pre-existing injuries or medical conditions, where the insurance company might blame your current condition on the past.

Intoxication: This is probably an obvious criterion, but an employee does not qualify for workers’ compensation if he or she was impaired when injured. Pennsylvania law states that no compensation is paid if the harm was caused by intoxication, whether an injury or death. Still, the burden of proof is on the employer to show that you were drunk or under the influence of drugs.

 Injuries Require Medical Treatment: Another requirement for workers’ comp is that your medical condition must be serious enough to require medical care, which most injuries are. It is important to get the treatment you need right away, whether at the ER, an urgent care, or your doctor’s office. An insurance company might assert that your injuries were not severe, but you will have medical records to support your claim.

 Talk to a Carbon County, PA Workers’ Comp Attorney About Options

This overview of eligibility for workers’ comp is helpful, but it is the details that really matter when insurance companies deny your claim. If you are experiencing challenges in getting the benefits you deserve, please contact the Law Office of Kim M. Gillen, P.C. We can set up a case review at our location in Lehighton, PA to discuss your circumstances. After evaluating your situation, a Pennsylvania workers’ comp lawyer will advise you.



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