Following cases of moderate to major surgery, some time off from work is to be expected. After surgery, it can be stressful for a patient to not only manage their day-to-day recovery, but also the fine print of work-related compensation. In the case of an injury at the workplace and workers compensation insurance — also known as “workers comp” — coming into play, questions on how to navigate the fine print while also facing a surgical procedure can cause additional stress. This especially applies to patients who work at smaller companies that may not have an HR department to answer their questions. To assist, consider this brief guide a way to address some of the workers comp questions you may have before or after your surgical procedure.

What is Workers Comp?
Workers comp is a state-mandated insurance your employers buy for work-related illnesses or injuries. Coverage begins on the date of hire. Should such an illness or injury take place, your employer is required by law to provide compensation for the medical procedure and potential lost wages if you are made unable to come to work. Federal employees are covered by one instance of workers comp, but other instances vary by state-to-state.

Who is covered by Workers Comp in Pennsylvania?
In Pennsylvania, nearly every employee is covered, including seasonal and part-time workers. The benefits are provided either by state or private insurance, and employers are required by law to provide it. This includes organizations such as non-profits and even one-man companies.

Employees that may not be covered by this law include the following, though note this subset is often covered by other PA compensation laws:

  • Federal civilian employees

  • Railroad workers

  • Longshoremen

  • Shipyard or harbor workers

Other potential employees that may not be covered in PA are volunteer workers, agricultural laborers, casual employees, domestics, and employees who have been granted a personal religious exemption.

In the case of your employer being exempted from providing workers comp to you, you are potentially eligible for the Uninsured Employer Guaranty Fund.

If you are unsure whether you are covered by your employer, you can contact your HR representative or the Bureau of Workers’ Compensation, toll free, at 800-482-2383; or locally and outside Pennsylvania at 717-772-4447.

What does Workers Comp Cover?
Workers comp covers all work-related illnesses or injuries, with exception to any related to illegal drug use or intoxication. Benefits include:

  • Payments for lost wages (in the case of missed work)

  • Death benefits (for surviving dependents)

  • Specific loss benefits (permanent loss of use for an extremity, hearing, etc.)

  • Medical care (such as in the case of surgery)

  • Payment amounts are approximately two-thirds of your average weekly wage, up to a weekly maximum.

How do I get Workers Comp Benefits?
It’s recommended that if you became ill or injured at your workplace that you file a workers comp claim as soon as possible. In the case of surgery, it is recommended you file your claim before you undergo your surgical procedure if at all possible. In the cases of severe injury, this may not be possible, so understand workers comp benefits and what you are entitled to post-surgery so you do not experience any undue stress while in recovery.

When undergoing a surgical procedure, minimizing stress is one of many keys to recovery. To learn more about applying for workers compensation, contact your primary care doctor today to discuss your local care options. For the latest PA-related workers comp information, also check the PA Department of Labor & Industry website.