How many work days must be missed to obtain wage-loss benefits?

If you have been injured at work and the injury has caused you to miss work, you are wondering if you are required to be compensated for those days missed.

In Pennsylvania, all employers are required to carry workers compensation insurance. If you are involved in a work-related injury, report the injury to a manager and/or supervisor immediately and make sure that the employer reports the injury to their workers’ compensation carrier. The insurance carrier then has 21 days to accept or deny the claim.

If the claim is accepted, you may be entitled to wage loss benefits depending on how many days you have been out of work. Wage loss benefits are payable on the 8th day after the injury. Once you are out of work for 14 days, then wage loss benefits are retroactive and wage loss benefits can be received for the first seven days as well.

In other words, if your injury caused you to miss only four days of work, you will not receive wage loss benefits.  If your injury caused you to miss 10 days of work, you can receive 3 days of lost wages.  If you injury caused you to miss 14 days of work, then you can receive lost wages for all 14 days. Wage loss benefits are typically two-thirds of your average weekly wage up to a maximum (currently $858 per week).

You will know whether you’ll receive wage loss benefits once you receive the workers’ comp insurance company’s acceptance or denial of your claim. If your claim is denied, speak to a workers’ comp attorney immediately. You may need to file a Claim Petition and litigate the matter to receive wage loss benefits.

If you experienced a work-related injury in Pennsylvania, please feel free to contact me for a consultation. Our office is located in Bethlehem, Pennsylvania and we are happy to assist injured employees throughout the Lehigh Valley area including Easton and Allentown.

What happens during an appeal to the Board of Review?

If you did not receive the outcome you had hoped for after your PA UC referee hearing, you have an additional appeal to the UC Board of Review. There are 15 days to file an appeal to the Board of Review after the UC referee has mailed their decision. The Referee’s Decision and Order will include instructions on filing an appeal to the Board of Review. An appeal can be filed simply by writing a letter providing your case information and the reason for your appeal.

It is often helpful to seek an attorney to file an appeal so they can clearly and correctly cite the applicable law that applies to the claim and establish a legal argument on why an employee should receive unemployment benefits based on PA UC Law.

No further hearings are conducted after the referee hearing. In fact, the referee hearing is generally the only opportunity for the Claimant and employer to admit evidence into the record. While a request for a remand hearing to take further testimony or evidence on an issue is permitted in some cases, it is rarely granted by the Board of Review.

Additionally, a party can request the Board’s permission to submit a legal brief to aid the Board in deciding the case. Submitting a brief can help maximize your chances of successfully appealing a case since a brief with summary of facts, statement of issues, and legal argument would be outlined in a organized fashion for the Board to review when they examine the case.

The Board of Review is a three-member panel that decides UC appeals after the referee hearing. The Board of Review will review the record and determine if the referee’s findings of fact and conclusions of law are supported by the testimony and evidence of the parties.  The Board of Review will receive a transcript of the referee hearing to read and they will also look at all of the documents and exhibits that are part of the record. Once an appeal is filed with the Board of Review, it often can take up to 75 days before the Board issues a decision.

If you are interested in filing an appeal to the Board of Review, please contact me at (484) 362-9286 to discuss your case.

What is a good reason to appeal a denial of UC benefits?

If you have been denied PA UC benefits, you are probably wondering what you will need to prove to be awarded benefits. There are several reasons a person’s unemployment benefits may be denied. The two most common sections of the PA UC Law are 402(b) and 402(e). Below are a list of reasons, arguments, and defenses to raise if you have been denied UC benefits.

Willful Misconduct – Section 402(e)

402(e) deals with the issue of willful misconduct. The most common situation where willful misconduct is found is in the case of a violation of an employer’s work rule. The employer will seek to deny benefits by showing the existence of the rule, the reasonableness of the rule, awareness of the rule (typically by signing an acknowledgement of receiving an employee handbook or prior warnings), and a violation of that rule.

Common defenses to willful misconduct include lack of awareness of the rule or that the violation thereof was unintentional. Other potential defenses include the employer not applying the work rules uniformly to all employees. Additionally, mere poor work performance is not a basis to deny an employee’s unemployment benefits provided that the employee worked to the best of their ability.

Voluntarily Quitting – Section 402(b)

Generally, if you voluntarily leave or quit your employment, you cannot receive unemployment benefits. However, there is an exception to this rule. In the event that you can establish that you had “necessitous and compelling reasons” for voluntarily leaving and you “exhausted all alternatives” prior to leaving the position, you may be entitled to receive unemployment benefits even if you quit your job. These types of issues are decided on a case-by-case basis and are primarily are left within the discretion of the UC referee or Board of Review. You must also establish that you are able and available for suitable work in order to receive UC benefits.

Discuss Your Case

If you would like to discuss your case with me during a consultation, feel free to call me at (484) 362-9286. I will be happy to discuss your case and inform you how your case will be decided depending on your circumstances.

What is the UC Service Center?

In Pennsylvania, the UC Service Center is responsible for processing unemployment compensation claims. They are the agency that receives applications for unemployment benefits. The UC Service Center assigns cases to their representatives for investigation and determination. The investigation consists of the representative asking the employee the reason for their application and confirming the reason for the Claimant’s application with the employer.

The claims representative is then required to issue a decision on a Claimant’s eligibility based on the information they received from both the employer and the employee. If a party disagrees with the decision made by the UC Service Center, they have the right to appeal the decision within 15 days to request a UC referee hearing.

UC claims representatives often have to decide claims based on incomplete information or conflicting information. Unfortunately, the claims representative often resolves conflicts in favor of the employer. However, by exercising your right to appeal, you’ll have an opportunity to present your case to the UC referee who will hear testimony from both parties and decide the case.

If you have been denied unemployment benefits, feel free to contact me at (484) 362-9286 to discuss your case.

How do temporary workers’ compensation benefits work?

I was injured on the job and received a Notice of Temporary Compensation Payable, what does this mean?

A Notice of Temporary Compensation Payable is a way for an employer’s insurance company to begin paying your wage-loss benefits without having to accept liability for the claim. The insurance company is essentially agreeing to pay wage-loss benefits on a temporary basis while they continue to investigate the claim and reserve the right to deny your claim if they believe that your injury was not work-related or for any other basis to deny a claim.

Temporary workers compensation benefits last for only 90 days. In order to stop your benefits, the employer must send a Notice of Denial within the 90 day period or a Notice of Stopping Temporary Compensation Payable within 5 days of the 90-day period elapsing. If neither notice if received within the required time period, workers’ compensation benefits will continue.

If you have received either a Notice of Denial or Notice of Stopping Temporary Compensation Payable, please contact me at (484) 362-9286. You have the right to file a Claim Petition seeking a judge’s order requiring the employer to continue paying your workers’ compensation benefits.

The Pennsylvania Unemployment Compensation Process

The purpose of this article is to outline how to apply for Pennsylvania unemployment benefits, how the Department of Labor decides an applicant’s eligibility, and what to do if a decision needs to be appealed.

Applying for Unemployment Benefits

You can apply for unemployment benefits by mail, phone, or online. The easiest way to apply for benefits is by Filing an Inital Claim on the Pennsylvania Department of Labor website. You’ll be asked a few questions about your work history and the reason your employment relationship ended. Be sure to answer each question truthfully. You do not want to indicate that you are applying for benefits due to a lack of work if you quit or were terminated for a rule violation.

Department of Labor Investigation

After receiving your initial application, you may be contacted by the UC Service Center for a phone interview or asked to complete a questionnaire if the Department of Labor needs more information in order to process your claim. The UC Service Center will also contact the employer regarding the reason the employment relationship ended and confirm information about the Claimant’s rate of pay and employment dates.

Notice of Determination

After the Department of Labor conducts an investigation, a Notice of Determination will be issued. There are two separate determinations that will be issued. The first will be a financial determination, which will inform you whether you’ve earned sufficient wages for the applicable time period to qualify for unemployment benefits.

The second determination will determine whether you or eligible for UC benefits or if any section of the PA Unemployment Compensation Law disqualifies you from receiving benefits. The two most common disqualifying sections of the law are if you voluntarily quit your employment or you were terminated due to misconduct.

The employer does not determine whether to grant unemployment benefits or not. Rather, the decision is made by the Department of Labor. In the event that benefits are awarded, the employer has the right to appeal the decision. If benefits are denied, the Claimant has the right to appeal the decision.

Appealing a Notice of Determination

If you were not awarded benefits, you have the right to appeal the Notice of Determination denying benefits. Please be advised that there are only 15 days to appeal the decision. The last day to appeal the Determination will be listed in the top-right corner of the Notice of Determination, as well as at the bottom of the Determination. Once an appeal is filed, the matter will be scheduled for a referee hearing where live testimony and evidence would be gathered from both the employer and the employee. It can take approximately 4-8 weeks before your referee hearing can be scheduled depending on the referee office’s current case load.

Referee Hearing Process

The referee hearing is an administrative hearing where testimony is taken under oath and recorded. The referee’s role is to obtain testimony and evidence on the issues affecting the employee’s claim for unemployment benefits. You have the right to be represented by an attorney during the referee hearing. You also have the right to subpoena witnesses and produce documents to support your claim.

At the beginning of the hearing, the referee will inform the parties about the hearing’s procedures and will review the documents in the record. The parties have an opportunity to object to the documents submitted that are part of the claim record.

The party who has the burden of proof on the issue testifies first. If the issue deals with willful misconduct, the employer will testify first. If the issue deals with the employee voluntarily leaving, the employee will testify first. After each party testifies, the opposing party can then cross-examine the testifying party. At the conclusion of the testimony, a closing argument can be made. The referee will usually issue a decision within 7-10 days from the date of the hearing.

Appealing the Referee’s Decision

There are two opportunities to appeal the referee’s decision. The first appeal is made to the UC Board of Review. The Board of Review will receive a transcript of the hearing and will receive all the documents that were part of the claim record. The Board of Review will determine whether the referee’s findings and fact and conclusions of law are supported by the evidence submitted.

An appeal to the Board of Review can be done in letter format. An attorney can file the appeal on your behalf and can also request the Board’s permission to submit a brief to outline legal arguments affecting the case. There are only 15 days from the date of the referee’s decision to appeal to the Board of Review. The Board of Review takes approximately 75 days to issue a decision.

If the appeal is still denied following the Board of Review’s decision, a final appeal to the Pennsylvania Commonwealth Court is permitted. Appeals to the Commonwealth Court are decided on briefs submitted. An appeal to the Commonwealth Court must be submitted within 30 days of the Board of Review’s decision.

Retaining an Unemployment Compensation Attorney

If you have any unemployment compensation questions or seeking legal assistance with an appeal, please contact me by calling (484) 362-9286. Our law firm represents clients in unemployment cases. Our law firm is located in Bethlehem, PA, and we are happy to help clients throughout the Eastern Pennsylvania area.