A Workers’ Late Notice of the Employer’s Uninsured Status Limits Both Medical and Wage Loss Benefits
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 workers’ compensation insurance, the Fund is NOT obligated to provide “compensation” from the date of the injury, but rather from the date the Fund received notice of the claim. The Court stated that “compensation” includes both wage loss benefits and medical benefits.
In this recent case, the Workers’ Compensation Judge (WCJ) had granted the injured worker’s Claim Petition against the Fund for both wage loss and medical benefits from the date of the worker’s injury. The employer appealed the WCJ’s decision to the Workers’ Compensation Appeal Board (WCAB). The WCAB agreed with the WCJ’s decision to grant medical benefits from the time of the worker’s injury, but it limited the worker’s receipt of wage loss benefits to the date that the worker had notified the Fund of the employer’s lack of workers’ compensation 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 Workers’ Compensation Act within 45 days after he knew the employer was uninsured, he could only receive workers’ compensation benefits for wage loss AND medical expenses incurred after the date notice was given to the Fund. In other words, because the worker’s 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 workers’ compensation benefits.