Who Pays for Workers’ Comp?

May 10, 2019

workers comp lawyers PhiladelphiaWorkers’ compensation programs vary by state. Generally, workers’ compensation benefits are paid for by either state-run insurance programs, employers, or employers’ private insurance companies. Pennsylvania employers with one or more employees are required to carry workers’ compensation insurance under the Pennsylvania Workers’ Compensation Act.

Injured employees are entitled to receive compensation for certain expenses associated with their work-related injuries or illnesses regardless of who was at fault. In exchange, workers may not sue their employers directly via personal injury lawsuits and workers’ compensation is generally their exclusive remedy.

Three Main Sources of Payment

In Pennsylvania, workers may receive various types of workers’ compensation benefits, including compensation for health care expenses, disability, and vocational rehabilitation. Injured workers are entitled to these benefits regardless of who pays for them, however there are three main sources of workers’ compensation payments. These include:

State-Run Insurance Programs

Typically administered by the state Department of Labor, state-run insurance programs collect premiums from employers throughout the state, which are then pooled and paid out to injured workers. Usually, employers with few employees or workplace injuries will opt for this type of coverage. In Pennsylvania, the State Workers’ Insurance Fund (SWIF) helps to provide workers’ compensation insurance for companies that cannot afford coverage.

Employers’ Self-Insurance

Employers may opt to self-insure their workers’ compensation plans for many reasons. Self-insuring lends employers the ability to select their own legal representatives and vendors and it may also help them to reduce costs by encouraging employers to take a more proactive approach to workplace safety. However, not all states permit self-insurance and if they do, employers must typically meet certain requirements.

In Pennsylvania, the requirements are that the company must have been in business for at least three years, there must be proof of incorporation or organization, and the employer must establish an accident and illness prevention plan. Employers who wish to self-insure must submit an application to the Department of Labor and Industry, along with the $500 application fee and proof of the ability to afford coverage.

Private Insurance Companies

Employers also have the option of purchasing their own workers’ compensation insurance through private insurance companies. Laws vary regarding private workers’ compensation insurance however most states allow this type of coverage. If your employer has private insurance, then you will be receiving your workers’ compensation payments from the insurance company.

Protect the Viability of Your Claim

In Pennsylvania, employees must notify their employers of work injuries no later than 120 days after the date of their injury to remain eligible for workers’ compensation. If you wish to file a claim, your employer must file a First Report of Injury with the Pennsylvania Bureau of Workers’ Compensation. Employers may deny claims if they believe that there is not enough information, that the injury did not occur at work, or that the injuries are not as described. It is therefore important to consult with an attorney in your local area to protect the viability of your claim.

Philadelphia Workers’ Compensation Lawyers at Larry Pitt & Associates, P.C. Help Workers Collect the Payments They Deserve

If you were injured at work, you are likely entitled to workers’ compensation benefits, paid for by either the state-run insurance program, your employer, or your employer’s insurance company. Contact an experienced Philadelphia workers’ compensation lawyer at Larry Pitt & Associates, P.C. for a free consultation by completing our online contact form or calling us at 888-PITT-LAW.

We proudly represent all types of injured workers in Philadelphia and throughout Pennsylvania, including those in Berks CountyBucks CountyChester CountyDelaware CountyMontgomery County, and Philadelphia County, as well as those in the communities of AbingtonAmblerArdmoreBala CynwydBensalemClifton HeightsCrum LynneDarbyDowningtownDoylestownDrexel HillEssingtonFolcroftGlenoldenHaverfordHavertownHolmesKutztownLansdowneMediaMerion StationMortonNarberthNorristownNorwoodPhiladelphiaProspect ParkQuakertownReadingRoxboroughSharon HillUpper DarbyWest Chester, and Wynnewood.