Reporting an employee who has been injured on the job
Report of occupational injury or disease must be filed:
- Within 48 hours for every injury resulting in death.
- Not before 7 days but no later than 10 days after the date of injury for all other injuries covered by the Workers' Compensation Act, except those cases resulting in no disability.
- Disability for reporting purposes shall be defined as (1) loss of time or wages beyond the day, shift, or turn in which the injury was received or (2) the loss or loss of use of a member or disfigurement which may qualify for a specific loss payment under section 306 of the act.
- After the employee has reported all injuries to their supervisor, manager, etc., as soon as possible.
- The employee must give notice within 21 days of the date of the injury in order to receive retroactive benefits, unless the employer already has knowledge of the injury.
- Notice given more than 120 days from the date of injury may result in the loss of workers' compensation unless the employer already knew of the injury.
- The employee should give as much information regarding the circumstances of the injury. The report may be made verbally or in writing by the employee or by someone acting in his/her behalf to the employer or to a representative of the employer.
Always report ALL injuries to SWIF, no matter how minor the injury may seem. SWIF should be notified by the employer if there is reason to doubt the claim, will investigate the claim to determine if the claim should be paid. If you have a posted panel of physicians, secure the injured employee's signature on the Workers' Compensation Employee Notification form. This should already have been signed at the time of hire.
Start by registering in WCAIS
Take charge of your Workers' Compensation information, eliminate paperwork, and reduce timelines by registering in WCAIS.
Please follow the steps below for registering:
- Select Are You a New User?
- On the Self-Registration User Selection screen, select the appropriate user group to register for WCAIS.
- Based upon your user type, follow the prompts on the subsequent screens.
- Read and agree to the WCAIS Data Release Agreement.
- Create a unique password.
- Verify that your information is correct, and Submit.
Frequently Asked Questions
Visit the WCAIS Training Resources page for a variety of training resources available to assist users in navigating through specific business processes in the system.
If an employee sustains a job injury or a work-related illness, the Pennsylvania Workers' Compensation Act, or Act, provides for your medical expenses and, and/or wage-loss compensation benefits until you're able to go back to work. Additionally, death benefits for work-related deaths are paid to your dependent survivors.
Benefits are paid by private insurance companies (also includes third-party administrators) or the State Workers' Insurance Fund (a state-run workers' compensation insurance carrier) self-insured employers.
Most PA workers, including seasonal and part-time, are covered by the Act. Even small employers must comply. Some exemptions apply, and alternative compensation laws cover specific groups. If your employer lacks insurance, contact the Bureau of Workers' Compensation for potential benefits. Call toll-free at 800-482-2383 or locally/outside PA at 717-772-4447.
Coverage begins on the date of hire. Medical benefits are payable from the first day of injury; payment of lost wages are addressed in the question, When are wage-loss payments made?
There are several types of insurance fraud:
Employee/ Claimant Fraud: where a person files for a claim or an injury that was not work-related or that never occurred.
Billing/Provider Fraud: where a provider bills for services never rendered or for more time/services than actually provided.
Premium/Insured Fraud: committed by underreporting payroll or misclassifying payroll/job classifications.
To report suspected workers’ compensation insurance fraud against the State Workers’ Insurance Fund please contact SWIF FIGHTING FRAUD or call 570-941-1644. All calls are confidential, but there may be times that we need additional contact and although you may remain anonymous, we would appreciate a contact number at which to reach you.
Please include the following in your allegation of suspected fraud:
- Name and Address (city) of the suspect i.e.; claimant, attorney, health care provider, employer or facility that you wish to report.
Reasons why you suspect that fraud is being committed. Please be specific where you can.
Additional information in your complaint may include:
Physical description of the claimant i.e.: height, weight, hair color/length and any other distinguishing characteristics. - Vehicle information: make, model, license etc.
The Insurance Fraud Prevention Authority (IFPA) also has set up an Insurance Fraud Hotline (toll-free) at 1-888-565-IFPA (4372) where you can phone in a fraud complaint for any insurance company doing business in Pennsylvania.
This document may help with any additional questions about your claim.