Workers’ Compensation Handbook
II. Work Injuries
The Workers’ Compensation Act covers any accident or injury related to employment, that is, any accident or injury that occurs within the course and scope of an employee’s employment. It is not necessary that the employee sustain the accident or injury because of the employer’s wrongdoing or negligence. All types of accidents and injuries are potentially covered under the Act, including the loss of use of a body part or loss of hearing, which will be discussed later in this booklet, as well as traumatic injuries and any aggravation of pre-existing injuries or conditions. For example, carpal tunnel syndrome, aggravations of diabetic conditions and in certain circumstances, heart attacks occurring at work or within six hours after work can be considered work injuries.
In addition, if an employee who previously underwent back surgery for an injury, which either occurred at work or elsewhere, re-injured his back at work, the re-injury can be considered a new work injury and be covered under the Act.
Injuries or diseases caused by exposures to dangerous substances or substances that cause pulmonary disease or other systemic diseases, such as cancer, may be covered under the Act. In some instances, aggravations of conditions like asthma can be covered if it can be proven that the condition has permanently worsened due to the employee’s work duties or environment.
Work-Related Aggravation of Pre-Existing Conditions
The work-related aggravation of a pre-existing physical or mental condition, which was not originally caused by work, can be a covered injury under the Act. If the activities of performing your job or the environment where you work aggravates or worsens a pre-existing medical condition, you may be entitled to benefits with the proper medical evidence.
The Workers’ Compensation Act recognizes that employees are often exposed to dangerous and toxic substances in the workplace. Asbestosis, mesothelioma, cancer, black lung, diseases caused by benzene exposure (Leukemia) and diseases caused by other toxic exposures are identified as occupational diseases and can be covered under the Act.
Diseases caused by workplace exposures can affect workers’ lungs, liver, bone marrow, skin, etc. The Act provides that any disease that is contracted as a result of exposure to a toxic substance at work, when that disease occurs more frequently in the workers’ occupation than in the general population, will be treated as a work injury.
In addition to the Workers’ Compensation Act, there is an Occupational Disease Act. If a worker has an occupational disease but is beyond the three-year statute of limitations required under the Workers’ Compensation Act, the worker may be able to recover benefits under this alternate Act. However, the benefit payments are less under the Occupational Disease Act than under the Workers’ Compensation Act.
Often a worker sustains an injury as a result o continuous and repetitive motion or activity that is performed as part of the worker’s job. This type of injury is identified as a cumulative trauma. This means that the worker is sustaining an injury every day he or she is at work. For example, a secretary that continuously types, folds paper, and stuffs envelopes may develop carpal tunnel syndrome as a result of those repetitive activities, which can be covered under the Act.
In a cumulative trauma case, there is no specific injury date but rather, a date of disability that triggers the worker’s entitlement to workers’ compensation benefits. The date of disability is when the worker can no longer perform his or her job duties because of the condition.
It is very common for employers to deny these types of claims by stating that they are not work-related because there was no specific event causing the injury. However, as noted above, each day at work contributes to the injury. Medical evidence would be necessary to relate the injury to the worker’s repetitive work activities which can also be used as the date of injury.
If an injury is self-inflicted, caused by the employee’s violation of law, or due to the employee’s intoxication or illegal use of drugs, the injury will not be covered under the Workers’ Compensation Act. If an injury occurs during a hostile attack on the United States or if the injury or death results from activities of the military or armed forces of the United States or from military activities or enemy sabotage of a foreign power, then no workers’ compensation shall be paid.
Sometimes the location where an employee is injured affects whether the injury is covered under the Act. Federal laws dictate the Workers’ Compensation Act when railroad workers, maritime workers, seamen, and federal civilian employees get injured on the job. For example, if a steelworker works at a steel mill but his primary job duties involve work on or near the navigable waterways, the claim may be covered under the Longshore and Harbor Workers’ Compensation Act. Seamen working aboard ships are also covered under the general maritime law and the Jones Act. The Federal Employees’ Compensation Act covers U.S. Postal Workers and other Federal civilian employees. These other compensation systems are very different from the provisions of the Pennsylvania Workers’ Compensation Act and if you believe that your situation may fall under one or more of these compensation systems, you should contact an experienced attorney.