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A Workers’ Late Notice of the Employer’s Uninsured Status Limits Both Medical and Wage Loss Benefits

By: Sandra Weigel Kokal

In a recent Commonwealth Court Case, the Court held that if an injured worker fails to notify the Uninsured Employers Guaranty Fund (Fund) within 45 days after the injured worker knows that the employer does not have workerscompensation insurance, the Fund is NOT obligated to provide compensationfrom the date of the injury, but rather from the date the Fund received notice of the claim. The Court stated that compensationincludes both wage loss benefits and medical benefits.

In this recent case, the WorkersCompensation Judge (WCJ) had granted the injured workers Claim Petition against the Fund for both wage loss and medical benefits from the date of the worker’s injury. The employer appealed the WCJs decision to the WorkersCompensation Appeal Board (WCAB). The WCAB agreed with the WCJs decision to grant medical benefits from the time of the workers injury, but it limited the workers receipt of wage loss benefits to the date that the worker had notified the Fund of the employers lack of workerscompensation insurance.

The Commonwealth Court reversed both the WCJ and WCAB decisions. The Commonwealth Court stated, in accordance with a recent PA Supreme Court decision, because the injured worker did not give notice pursuant to the WorkersCompensation Act within 45 days after he knew the employer was uninsured, he could only receive workerscompensation benefits for wage loss AND medical expenses incurred after the date notice was given to the Fund. In other words, because the workers notification to the Fund was late, the Fund was NOT required to pay for medical or wage loss benefits prior to receiving formal notice of the claim.

As this case demonstrates, you should consult with an experienced workers’ compensation attorney so you do not miss any important notice requirements and forfeit your workerscompensation benefits.

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