The Pennsylvania Workers’ Compensation Act requires employers to provide their workers with workers’ compensation benefits for work-related injury or illness (unless the injury is self-inflicted or due to illegal activity). Types of benefits include medical care, lost wages, death benefits (to dependants) and specific loss benefits. Workers’ Comp. coverage begins on the hiring date. Medical benefits are payable from the first day of the injury. To receive payments for lost wages, you must be disabled more than seven days. Benefits for time lost will be payable on the eighth day after your injury. You will receive retroactive payment for the first seven days after being off work for 14 days.
To receive benefits, you must report your injury or work-related illness to your employer or supervisor. You should do this as soon as possible such as to avoid delay or denial of your benefits. You will need to provide your employer with the date, place, time and nature of your injury or illness. Your employer is required to report your injury to the Bureau of Workers’ Compensation as soon as you have lost a work day or work shift. Your employer will either accept or deny your claim. If denied, you have the right to file a claim petition with the bureau for a hearing before a Workers’ Comp. judge. He/or she will likely require you to attend mediation or other forms of alternative dispute resolution for purposes of settling the case. If the Workers’ Comp. judge denies your petition, you can appeal to the Workers’ Compensation Appeal Board and then to Commonwealth Court in the appropriate county. An appeal of the Superior Court’s ruling can be filed with the Pennsylvania Supreme Court.
Total Disability vs. Partial Disability
Injured workers will receive total disability benefits during the period they are deemed totally disabled and unable to work. Your employer or their insurance company require a medical examination after 104 weeks to determine if you are at least 50% impaired based upon his/her work injury according to American Medical Association standards. If you are not found to be beyond 50% impaired, your disability status can change to partial. Partial benefit are paid out for a maximum of 500 weeks. If, while receiving partial disability status, a qualified impairment-rating physician determines your impairment is equal to or greater than 50%, you can elect to file a petition for reinstatement of total disability status.