Facts about PA Workers’ Comp. that People May Not Know
When an insurance company for an employer (or a self-insured employer) picks up a claim and pays benefits to a claimant, they are classified as “total disability” benefits because the claimant is totally disabled. The benefit rate is calculated based on 2/3 of the claimant’s average weekly wage at the time of the injury, although that percentage can be lower than 2/3 if the claimant’s wages are at the higher end, or higher than 2/3 if the wages are on the lower end. The claimant is entitled to total disability benefits until one of the following occurs: (1) A workers’ compensation judge terminates benefits, finding that the claimant has fully recovered from the work injury; (2) the claimant and employer enter into a settlement of the claim. Normally, when a case settles, the claimant is paid a lump sum of money, and the claim ends; (3) The claimant returns to work; (4) A workers’ compensation judge modifies or suspends the claimant’s benefits on the basis that the claimant has failed to return to work within his or her medical restrictions, or the employer establishes that the claimant is able to work and there are jobs in the area within the claimant’s restrictions.
Under Scenarios 3 and 4, the claimant’s benefits will be converted to “partial disability” and will be reduced to 2/3 of the difference between the average weekly wage and the wages earned at the job returned to or the earning power established by the judge. So let’s say a claimant has been paid total disability benefits at the weekly rate of $600 based on an average weekly wage of $900.00. If the claimant returns to a position earning $450 per week – or the judge determines a claimant has a weekly earning power of $450, the claimant’s benefits will be reduced to $300: $900-$$450 = $450 x 2/3 = $300. Unlike total disability benefits, a claimant may not receive partial disability benefits indefinitely – these benefits are limited to 500 weeks.
This is a very complicated process. Whether you are receiving total disability benefits, or partial disability benefits; your claim has been denied; or you have just been injured and are not sure what to do, call Pearson Koutcher Law and allow one of our very experienced and skilled workers’ compensation lawyers to answer all of your questions, and if necessary, represent you in your claim.
Call Pearson Koutcher Law to Discuss Your Workers’ Compensation Claim
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Philadelphia, PA 19103
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Bethlehem, PA 18018
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Cherry Hill, NJ 08003