Types of Workers’ Compensation Benefits
You may receive wage loss benefits if your work injury has prevented you from doing your job. The amount you are entitled to is based on the wages you earned for your employer. Using on a formula which takes into account your wages over the one-year period before the injury, your “average weekly wage” is calculated. Based on that figure, your weekly workers’ compensation rate is determined, which ranges from 2/3 (if your wages are in the higher range) to 90% (if your wages are in the lower range) of your average weekly wage. These are called “total disability” benefits. If your work injury prevents you from performing your regular job, but you are able to work in a part-time and/or a light-duty position earning wages that are less than what you were earning at the time of your injury, you are entitled to “partial disability” benefits. These are designed to make up the difference between what you were earning at the time of the injury and what you are making in the lower paying position. This is calculated based on 2/3 of the difference between your “average weekly wage” and reduced wage.
The second major benefit you are entitled to if you sustain an injury at work is payment of your medical bills. A big advantage is that you will not be required to incur co-pays to doctors and pharmacies as you mostly like would if you submitted the bills to a private health insurance company. The workers’ compensation insurance company for your employer is required to pay the medical bills that are related to your work injury – in other words, if the medical treatment was caused by your injury on the job, it is their responsibility to pay. It sounds straightforward, but workers’ compensation insurance companies frequently deny paying medical bills for a variety of reasons. An example would be they are paying the bills for treatment to your neck, the injury which they agree you sustained in the accident at work, but not for your back, which they claim wasn’t injured in the accident.
The medical treatment must also be reasonable and necessary in order for the insurance company to be required to pay. Insurance companies often challenge paying for treatment on the basis that the treatment is unreasonable and unnecessary. This sometimes arises if an injured worker undergoes extensive chiropractic or physical therapy treatment, and the insurance company believes the injured worker is no longer getting any benefit from the treatment.
A less common benefit that you may be entitled to is money for the “specific loss” of a body part. You must establish that you have permanently lost the use of a body part for all practical intents and purposes. It is not enough to show that the injury to that body part prevents you from doing your job; it must be more severe than that. Pennsylvania workers’ compensation law provides a table listing the number of weeks of benefits (based on your weekly total disability compensation rate) you would get for the specific loss of each body part. For example, the loss of a leg would entitle you to 410 weeks of benefits; a loss of a thumb would be worth 100 weeks.
You may also be entitled to benefits if your work injury causes disfigurement (scars, burns) to your head, face, or neck. The disfigurement must be permanent and unsightly — unpleasant to look at. The workers’ compensation judge assigned to your case may award you between 0 and 275 weeks of benefits depending on the severity of your disfigurement.
Any benefits that you receive for your work injury – total disability, partial disability, specific loss, or disfigurement – are non-taxable.
So if you injure yourself at work, we urge you to contact Pearson Koutcher Law and speak with one of our knowledgeable and experienced workers’ compensation lawyers, who will explain to you the benefits that you are entitled to and file the necessary petitions on your behalf to help you secure those benefits.
Call Pearson Koutcher Law to Discuss Your Workers’ Compensation Claim
Let us put our decades of experience to work for you, helping you navigate the complexities of the Workers’ Compensation laws.
Pearson Koutcher Law
1650 Arch Street
Philadelphia, PA 19103
Bethlehem Office serving the Lehigh Valley
528 Maple Street,
Bethlehem, PA 18018