The Commonwealth of Pennsylvania provides an excellent summary of various questions and answers to many issues involving worker’s compensation. Below are some of the more frequent questions and answers.
In Pennsylvania, disputed workers’ compensation cases are handled by Workers’ Compensation Judges (WCJs) within the Workers’ Compensation Office of Adjudication. There are over ninety WCJs located in twenty-five offices throughout the Commonwealth.
Q: How Does My Case Get To A WCJ?
A: The injured worker, employer or insurance company files a petition with the Bureau of Workers’ Compensation.
Q: How Will I Know When A Petition Is Filed By The Other Party?
A: The party filing the petition must send a copy to all other parties. The Bureau of Workers’ Compensation will then send you a “Notice of Assignment” telling you that a petition has been assigned and identifying the WCJ who will hear the case.
Q: What Types of Issues Go Before WCJs?
A: Common petitions types include:
Claim: Used to establish that an employee is entitled to benefits for a disputed work injury.
Termination: Injured worker is fully recovered from a work injury, and is no longer entitled to any workers’ compensation benefits from that injury.
Suspension: Injured worker is not fully recovered, but has either returned to work or is capable of returning to available work without a loss of earnings.
Modification: Injured worker is not fully recovered, but has either returned to work or is capable of returning to available work with some loss of earnings.
Review: Correct errors in compensation documents (such as description of injury or average weekly wage).
Review Medical: Establish whether specific health care is related to a work injury.
Utilization Review: Address whether specific health care treatment is reasonable and necessary.
Seek Approval of A Compromise and Release: Ask a WCJ to approve a proposed settlement.
Employee Challenge: Whether a Notification of Suspension or Modification (filed by the employer when the injured worker returns to work) is correct.
Q: How Are Petitions Assigned?
A: When a petition is filed, the Petitions Section of the Bureau of Workers’ Compensation, located in Harrisburg (“Bureau”) will assign the petition to a WCJ who hears cases in, or near, the county where the employee resides. You will then receive the “Notice of Assignment”.
Q: What Happens After the Petition Is Assigned?
A: It may be essential that the responding party file an Answer within a specific time limit. Information concerning the filing of the answer is contained on the Assignment Notice.
Any employer receiving a blank answer form should promptly contact the workers’ compensation insurance company or adjusting company.
The WCJ will schedule a hearing shortly after receiving the petition assignment. The WCJ’s office will mail you a written notice telling you the time, date and place of the hearing.
Q: What If I Can’t Get To The Hearing?
A: If there is a good reason why you can’t attend the hearing, you must tell your attorney as soon as you get this notice. If you don’t have an attorney, you must write to the assigned WCJ and ask for a postponement of the hearing. Explain the reasons you can’t get to the hearing. You must ask the other side’s attorney if there is an objection to the postponement request, and tell the WCJ what the attorney says. You must send a copy of your letter to the other side’s attorney. The WCJ will notify all parties and their attorneys if the postponement is granted.
Not all postponement requests are granted. Never assume that your hearing has been postponed unless the WCJ’s office tells you it has been!
Q: Do I Need An Attorney?
A: To read more about having an attorney, click here: Lawyer Referral Service
Q: Can I Bring Someone To The Hearing With Me?
A: You can bring a spouse, parent, or friend with you. They may not speak on your behalf unless called to testify as a witness. If so, they might be instructed to leave the room while other witnesses testify.
Q: What Will Happen At The Hearing?
A: The WCJ will ask both parties what evidence they intend to present. One or both parties may present testimony or submit documents, or both. The WCJ will set a schedule for the submission of all other evidence. More information concerning the WCJ’s first hearing procedures may also be obtained at the Office of Adjudication Judgebook.
Q: Will I Testify At the Hearing?
A: The injured worker usually testifies before the WCJ at some point in the case. In many cases, injured workers testify at more than one hearing. Employer representatives also frequently testify before the WCJ. Whether you testify at the first hearing (or at all) depends on the type of petition, whom the law requires to submit evidence first, the WCJ’s case management rules and your attorney’s advice. If you do testify, your testimony will be taken down by a court reporter.
Q: Should I Bring Evidence With Me To The Hearing?
A: You should discuss with your attorney in advance what items to bring to the hearing. If you do not have an attorney, you should bring at least three copies of any document that you want the WCJ to consider. (One copy is for the WCJ, one must be given to the other party and one is for you.) Since the WCJ is bound by the rules of evidence, the WCJ may be unable to consider some or all of the documents you offer. The WCJ will address this at the hearing if it happens.
Q: Will I Get A Decision At The Hearing?
A: In disputed cases, no. The law requires the WCJ’s final decision to be in writing. Also, there is almost always more evidence to be given to the WCJ before the case can be decided. It often takes time to gather this evidence, especially medical records and testimony. Even if no additional evidence is needed, both parties usually want to file briefs.
Q: What Will Happen After The Hearing?
A: In most cases, one or both parties must collect and offer more evidence. Many cases require the scheduling of medical depositions by both parties. It can take a number of months to gather this information. The WCJ often schedules additional hearings to receive this additional evidence.
Q: How Will I Know What The WCJ Decides?
A: The WCJ must send a written decision to all parties. The decision is sent after all of the evidence and briefs have been given to the WCJ. You and your attorney will receive the decision in the mail.
Q: What If I Disagree With How The WCJ Decided The Case?
A: You have the right to appeal a WCJ’s decision to the Workers’ Compensation Appeal Board. Information on the time limit to appeal will appear on the WCJ decision’s cover letter. Whether your appeal succeeds will depend on a number of factors. You should discuss any possible appeal with your attorney as soon as you get the WCJ’s decision.
Q: Should I Settle My Case?
A: You cannot be forced to settle your case. It’s always up to you whether you want to talk settlement with the other party. For more details about the settlement process, read our brochure here: ADR Brochure
Q: How Do I Go About Talking Settlement?
A: Settlements are negotiated between the parties. If the parties have attorneys, the attorneys usually represent them in settlement discussions. The parties can negotiate directly with one another, or they can use a mediator. The Office of Adjudication provides WCJs who conduct mediations and settlement conferences in litigated cases.
Q: Is There Someone I Can Call If I Have Other Questions?
A: The Bureau of Workers’ Compensation has Helplines available. These Bureau employees do not provide legal advice. However, they are able to provide answers to many questions concerning workers compensation in Pennsylvania.
If you are an injured worker, call 1-800-482-2383 (toll-free inside PA) or (717) 772-4447 (locally and from outside PA). If you are seeking information on behalf of an employer, insurance company, or adjusting company, call 717-772-3702. People with hearing loss may call TTY 1-800-362-4228 (toll-free inside PA) or (717) 772-4991 (locally and from outside PA).