We Represent Employers in Cases of Pennsylvania Workers’ Compensation Defense
Effective management of your workers’ compensation claims is as important to us as it is to you
According to the Pennsylvania Department of Labor & Industry, the average weekly compensation for injuries occurring after January 1, 2013 is $917 per week — a 3.3 percent increase over 2012. As an employer, you have the responsibility to provide workers’ compensation coverage to your employees. You also have the right to protect your business against claims that are fraudulent, unwarranted or unrelated to work activities, or for injuries caused by your employee’s drug or alcohol use. Given the increase in weekly benefits, medical costs, settlements and number of claims, employers and their insurers have an interest in assessing and mitigating risks. And as Pennsylvania workers’ compensation defense lawyers, so do we.
At High Swartz, LLP, we recognize the effect even one significant workers’ compensation claim can have on your profitability and insurance premiums. We develop sound strategies for self-insured, commercially insured and uninsured employers and their third-party administrators — and have since 1974. As workers’ compensation defense lawyers who also help the injured to file for workers’ compensation, we understand the laws as they apply to both employers and employees, and we use this knowledge to advance an employer’s case.
What is an employer’s workers’ compensation responsibility?
Under Pennsylvania law, you are required to have workers’ compensation coverage if:
- You have at least one employee who could suffer an injury or work-related disease in Pennsylvania.
- Employment is localized in Pennsylvania, but your employee could be injured in a state other than Pennsylvania.
- Your employee is under a contract of hire made in Pennsylvania but could be injured outside the state of Pennsylvania, the employment is not localized in the state, the workers’ compensation laws in the state in which employment is localized do not apply, or employment is not within the United States or Canada.
Common reasons for claims denial
Eligibility for any workers’ compensation claim must include these elements:
- The injured party must be an employee, not an independent contractor.
- An injury must have occurred within the “course and scope of employment.”
- In cases of occupational diseases, there must be a connection between the medical condition or disease and the work performed.
Claims may be denied because a worker was intoxicated, assuming that the injury happened because of the drug or alcohol use and was not an injury that would have occurred whether the employee was intoxicated or not.
Willful misconduct is another common reason for denial and includes violations of work or safety rules that lead to an injury. Horseplay or goofing off during work may be a defense against a workers’ compensation claim, but under Pennsylvania law, it must be proven that this behavior is not considered to be unacceptable in the scope of the employee’s duties.
No employee is eligible for workers’ compensation benefits for a self-inflicted injury.
Areas in which our workers’ compensation defense attorneys can help
Our focus is on providing advice and counsel for employers in every aspect of risk assessment, claims mitigation strategy, negotiation, mediation and litigation. Our goal is to effectively reduce your organization’s claims liability. To that end, we are proactive and also offer in-service seminars and consultations to our clients about a range of workers’ compensation topics.
Our experience is a key ingredient in successful workers’ compensation defense matters. Our workers’ compensation lawyers help employers throughout southeastern Pennsylvania defend against fraudulent or unwarranted workers’ compensation claims.