Workers' Compensation Lawyer: Help for Injured Workers in Philadelphia and Delaware County

Do you need a workers' compensation lawyer?

You don't have to hire a lawyer to file for workers' comp in Pennsylvania, but you should talk to one if your claim was denied, your checks stopped, you were sent to an insurance doctor, or someone other than your employer caused the injury. Those are the points where injured workers lose benefits they were entitled to.

The Pennsylvania Workers' Compensation Act (77 P.S. § 1 and following) covers nearly every worker in the state, including part-time and seasonal employees. It pays medical treatment for a work injury and, if you can't work, a share of your wages. In exchange, you generally can't sue your employer. The state's own guide for injured workers points out that the employer's insurer will have an experienced attorney, and that non-lawyers can't represent you before a workers' compensation judge.

Report the injury: the 21-day and 120-day notice rules

Tell your employer or supervisor about the injury right away, and say that it happened at work, when and where. Put it in writing if you can and keep a copy.

Timing matters. Under Section 311 of the Act (77 P.S. § 631), if your employer doesn't already know about the injury and you don't give notice within 21 days, no compensation is due until notice is given. If notice isn't given within 120 days of the injury, the claim is generally barred. Some injuries, such as repetitive strain or an illness that develops slowly, raise hard questions about when the clock started, which is one more reason to report early.

Once you lose a day, shift or turn of work, your employer must file a first report of injury with the Bureau of Workers' Compensation. The insurer then generally has 21 days from your notice to accept the claim, deny it, or start temporary compensation.

What workers' comp pays in Pennsylvania

Workers' comp is a set of defined benefits, not a lawsuit for everything you lost. It does not pay for pain and suffering. What it can pay:

• Wage loss: roughly two-thirds of your average weekly wage while you are totally disabled, up to a weekly maximum the state sets each year. For injuries on or after January 1, 2026, the maximum is $1,394.00 a week.
• Partial disability: if you return to lighter, lower-paying work, a benefit based on the wage difference, for up to 500 weeks.
• Medical care: reasonable, necessary treatment related to the injury, including surgery, hospital care, medicine, supplies and prostheses, for as long as they are needed. Providers can't balance bill you for the difference.
• Specific loss: a scheduled number of weeks of benefits for the permanent loss or loss of use of a body part, sight or hearing, or for serious, permanent disfigurement of the head, face or neck.
• Death benefits: payments to surviving dependents when a work injury is fatal.

How wage loss benefits are calculated

The starting point is your average weekly wage before the injury, which the insurer calculates from your earnings. Mistakes are common. Overtime, a second job, or a recent raise can be left out, and every dollar missing from the average shrinks every check that follows.

Benefits start once you've been disabled more than seven calendar days. If you're out 14 days or more, you're paid back for the first seven. If the claim is accepted and you reported it promptly, the Bureau says the first check should usually arrive within 21 days of your time out of work. Wage loss can be offset by some other income, including half of Social Security retirement benefits, the employer-paid part of a pension, severance and unemployment compensation.

Medical treatment and the 90-day panel doctor rule

You can generally choose your own doctor. The exception: if your employer accepts the claim and has posted a list of at least six approved health care providers at your workplace, you must treat with a provider on that list for the first 90 days after your first visit. If you go outside the list during those 90 days, the insurer can refuse to pay for that care. After the 90 days, you can treat with a provider you choose, but you must tell your employer who it is.

If a listed provider recommends invasive surgery, you're entitled to a second opinion paid for by the employer or insurer. Keep every appointment, follow the treatment plan, and tell each provider the injury happened at work so the bills go to the comp carrier and not your health insurance.

Insurance doctor exams (IME) and impairment rating evaluations (IRE)

Once you're receiving benefits, the insurer can ask you to see a doctor it chooses. This is usually called an independent medical exam, although the doctor is picked and paid by the insurer. If you refuse, a judge can order you to attend, and skipping an ordered exam can get your benefits suspended. The report from that visit is often the basis for a petition to cut off or reduce benefits.

After you've received 104 weeks of total disability benefits, the insurer can also require an impairment rating evaluation. If the rating comes in below 35 percent under the American Medical Association guides, your status can be changed to partial disability, which starts the 500-week limit. A worker whose later rating reaches 35 percent or more can petition to go back to total disability. These exams are technical, and the numbers have long-term consequences, so talk to a lawyer before or right after one.

Specific loss benefits

Specific loss benefits are paid for a permanent injury to a scheduled body part, whether or not you missed time from work. Section 306(c) of the Act sets the number of weeks for each loss. For example, the schedule lists 410 weeks for the loss of an arm or a leg, 335 weeks for a hand and 275 weeks for an eye, plus a healing period for each. Permanent loss of use counts the same as an amputation, so a hand you can no longer use can qualify even though it wasn't removed.

Whether an injury rises to a loss of use is often disputed, and the medical evidence decides it. Serious, permanent disfigurement of the head, face or neck is also compensable, up to 275 weeks.

Claim denied or benefits stopped? The claim petition

A denial is not the end of the claim. If the employer or insurer denies your claim, or stops temporary compensation within the first 90 days, you can file a claim petition with the Workers' Compensation Office of Adjudication. A workers' compensation judge will hear medical evidence and testimony from both sides and decide the claim. Many cases also go through mediation with a judge along the way.

The deadline is generally three years from the date of injury (Section 315). If benefits were terminated after being paid, a petition to reinstate generally must be filed within three years of the last check. A judge's decision can be appealed to the Workers' Compensation Appeal Board and then to the Commonwealth Court.

Benefits can also be cut off later. The insurer may file to stop or reduce checks based on an exam, a job offer within your restrictions, or a claim that you've recovered. Payments generally continue while the judge hears it unless the judge orders otherwise.

Settling a workers' comp claim: compromise and release

Many claims end with a compromise and release agreement under Section 449. You give up some or all future rights under the Act in exchange for a payment. The agreement must be in writing, it must spell out whether future medical bills will be paid, and it doesn't take effect until a workers' compensation judge approves it at a hearing after confirming you understand what you're giving up.

Whether a settlement makes sense depends on your medical future, your ability to work, and whether medical coverage stays open. Once approved, it's very hard to undo. Don't sign one without independent advice.

Third-party claims alongside workers' comp

The Act generally bars suing your employer, but it does not protect everyone else. If a person or company other than your employer caused or contributed to your injury, you can bring a separate personal injury claim against them. That claim can include pain and suffering and full lost earnings, which comp never pays.

Common examples: a delivery or sales driver hit by a negligent motorist on West Chester Pike or I-476, a worker hurt by another contractor's crew on a construction site, or a fall caused by a hazard on property owned by someone other than your employer. See our construction accident page for how these claims work on job sites.

Under Section 319, the comp insurer has a lien on a third-party recovery for the benefits it paid, with attorney fees and costs shared in proportion. Money above the lien goes to you and is treated as an advance against future comp benefits. Coordinating the two claims is where a lawyer can make a real difference in what you keep.

Where these cases are heard and how we can help

Workers' comp hearings are held before workers' compensation judges, not in the county courts. A third-party injury lawsuit is filed separately, usually in the Delaware County Court of Common Pleas in Media or the Philadelphia Court of Common Pleas at City Hall, depending on where the injury happened and where the defendants do business.

Warren Siegel has practiced in Pennsylvania since 1992 from the firm's office at 8000 West Chester Pike in Upper Darby, serving injured workers across Delaware County and West Philadelphia. He can look at your notice, your wage calculation, your medical evidence and any third-party claim together.

Fees: the firm works on contingency. There is no attorney fee unless we recover, and the firm advances case costs, which are repaid only from a recovery. In workers' comp matters, the Act also requires a judge to approve the fee agreement and caps the fee at 20 percent of the compensation awarded. To talk it through, call (267) 412-4601 or send the free case review form.