What Is NOT Covered By Workers’ Compensation In Pennsylvania
An employer’s workers’ compensation insurance covers employees’ injuries and illnesses related to or sustained at work. When you qualify for workers’ compensation benefits in Pennsylvania, the coverage covers your medical bills, lost wages, specific loss and some physical disfigurement
However, not all employees are eligible for workers’ compensation in Pennsylvania. Read on to find out what is not covered by workers’ comp insurance in Pennsylvania.
If you have been injured in an on-the-job accident or developed a work-related illness, speak with a Harrisburg workers’ compensation attorney to determine if you qualify for coverage.
- Activities Not Related to Work
In most cases, workers’ compensation does not cover injuries arising from activities not related to work. Under Pennsylvania law, workers’ compensation provides coverage for employees injured in the course and scope of employment.
Thus, if you sustained injuries outside of the workplace and outside of regular business hours, you may be barred from obtaining workers’ compensation benefits.
However, it is essential to consult with a lawyer to determine if the activities you performed at the time of your injury would qualify as work-related. Previously, we discussed if employees are entitled to workers’ compensation benefits for injuries sustained while working at home. (CAN YOU ADD LINK TO THIS ARTICLE)
- Reckless Activities
Being reckless at the time of your workplace accident may disqualify you from workers’ compensation in Pennsylvania. For example, if you did not use safety equipment to protect yourself from injuries at work, the resulting injuries may not be covered by workers’ compensation. These are very fact intensive cases.
Under Pennsylvania law, employers are allowed to deny workers’ compensation claims, if the Employer establish that the injury was caused by a worker’s use of alcohol or illegal drugs.
If your employer’s insurance company denied your workers’ compensation claim because you engaged in alleged reckless activities, it is advisable to discuss your case with a Harrisburg workers’ compensation lawyer to determine if you can appeal the denial.
- Unreasonable Medical Treatment
Workers’ compensation only pays the bills for any treatment that is reasonable, necessary and related to the work injury. Thus, if your employer’s insurance company thinks that your medical treatment is unusual, unreasonable, or medically unnecessary, it may file a Utilization Review and deny coverage for medical bills pending the outcome of the Utilization review.
- Workers Who Are Excluded From Coverage
Under Pennsylvania law, employers are required to provide benefits to full-time, part-time, and seasonal workers.
However, some workers are excluded from workers’ compensation coverage. For example, independent contractors are not covered by workers’ compensation in Pennsylvania.
If your workers’ comp claim was denied because you are an excluded worker, contact a knowledgeable attorney to determine if it is still possible to get compensated for your injury.
Who’s Excluded from Workers’ Compensation in Pennsylvania?
While most Pennsylvania employers are required to provide workers’ compensation coverage to their employees, some workers are exempt from the benefits:
- Typically, companies that employ federal workers are not required to carry workers’ compensation insurance to cover federal employees. Many federal employees are already covered under other workers’ compensation acts.
- Agricultural employees who work less than 30 days or earn less than $1,200 a year are exempt from workers’ comp coverage.
- Some employees request an exemption from workers’ compensation benefits due to religious beliefs.
- Some employees who have executive status in the company are exempt from workers’ comp coverage.
Do not hesitate to consult with our experienced workers’ compensation attorney at Ira H. Weinstock, P.C., to determine if you are covered by workers’ comp in Pennsylvania. Call 717-238-1657 to schedule a case review.
