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Workers' Compensation

The Pennsylvania Workers' Compensation Act provides medical benefits and payment for lost wages to Pennsylvania employees who sustain a work-related injury or illness through the course of employment. Workers' compensation coverage is mandatory in Pennsylvania. The Workers' Compensation Packet contains three important forms - the Information Form, the Acknowledgement of Employee Rights and Duties and the Supervisory Injury/Illness Report.

When you become injured or ill on the job ...

You must follow this procedure in order to be awarded workers' compensation. For more information and a detailed procedure, see the Workers' Compensation Summary Information (.pdf)

1. If your injury is severe, call Campus Security at 8-2323 for immediate transportation to CONCENTRA or UPMC Shadyside for emergency treatment OR
2. If your injury is not an emergency, call CONCENTRA at 412-621-5430 to schedule an appointment
3. Inform your manager ASAP (within 24 hours) so that you and s/he can complete a Supervisor's Injury/Illness Report (.pdf) and the Acknowledgement of Employee Rights and Duties (.pdf) form.
4. Your follow-up care will be provided for the next 90 days by a Panel Physician at CONCENTRA
   NOTE: If you do not choose to have your follow-up treatment provided by a Panel Physician, you will pay all expenses yourself.
5. After 90 days, if additional treatment is required, you can choose your own physician after notifying your supervisor and the Benefits Office within 5 days.

NOTE: If you are injured and medical treatment is not immediately/apparently required, you should still complete the appropriate forms to put the injury on record.

Benefits

Through Workers' Compensation, you can receive the following benefits:

• Payment of Medical Expenses - Reasonable and necessary medical expenses are paid for work-related injuries or illnesses even if the employee does not miss any days away from work. Medical benefits are paid for as long as the employee requires treatment for the work related injury or illness.
• Replacement of Lost Wages - An employee is paid a portion of his/her salary if the employee is unable to work due to a work-related disability, up to a maximum amount per week as provided by law. Payment begins after 7 calendar days. This is known as the 'waiting period.' If an employee is unable to work for more than 14 calendar days, then benefits begin retroactively as of the date of disability.
• Specific Loss Benefit - Benefits are payable, in specified amounts as defined by law, for the loss of vision, hearing, and/or the use of a limb, including fingers and toes.
• Disfigurement Benefits - Benefits are payable for serious, permanent disfigurement of the head, face or neck.
• Death Benefits - An employee's dependents may claim benefits if an employee dies due to a work-related injury or illness.

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For more information:

• Workers' Compensation Summary Information (.pdf) - for procedure, frequently asked questions and more information
• Workers' Compensation Information Acknowledgement (.pdf)
• Supervisor's Injury/Illness Report (.pdf)
• Acknowledgement of Employee Rights and Duties under ... Pennsylvania Workers' Compensation Act (.pdf)
• Workers' Compensation Medical Panel (.pdf)
• Return To Work Certification Form (.pdf)
• Pennsylvania Department of Labor and Industry - Workers' Compensation FAQ

© Carnegie Mellon Human Resources 2004