Payments are made while the worker is temporarily unable to perform any work and are based on 2/3 of the injured individual’s average weekly wage. They are paid for the duration of disability. Although it is theoretically possible to receive wage-loss benefits for life, this is not common. For injuries after 06/24/1996, once 104 weeks of total disability benefits have been paid, the individual may have to submit to a medical examination to determine the extent of their permanent impairment.

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  If their impairment rating is 50 percent or greater the individual continues to receive total disability benefits and will be considered totally disabled. The individual must be profoundly disabled in order to receive an impairment rating of greater than 50 percent.

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  If the impairment rating is less than 50 percent, the individual is deemed to be only partially disabled. At that point WC payments are limited to no more than an additional 500 weeks.

This is paid when the injured worker cannot return to regular work and is given a light duty job at a lower wage, or is found not totally disabled. It is generally paid at 2/3 of the difference between the worker’s wages before and after their injury. The maximum period that can be awarded is 500 weeks. If, while on partial disability status, the worker receives a determination of impairment which is equal to or greater than 50 percent, they may file a petition for reinstatement of total disability status.

The Pennsylvania Workers' Compensation Act contains a schedule of ‘specific losses’ that lists the benefits paid for a permanent loss or loss of use of certain limbs or functions of the body. The law fixes a specific number of weeks for each specific loss. The individual is entitled to receive these benefits for the period allotted regardless of whether or not they are out of work. Injured employees are compensated for scheduled losses based on 2/3 of their pre-injury wage, multiplied by the number of weeks established for the loss in question. Scheduled awards are paid in addition to TT at the end of TT and are not reduced for TT previously paid.

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  Disfigurement benefits are paid for serious and permanent disfigurement of head, face, or neck. This type of Scheduled Award has a maximum period of 275 weeks.

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  Healing period benefits are also mandated by the schedule. These are additional weeks of WC paid until either the injured individual returns to work without an impaired earnings capacity, or the scheduled amount has been paid, whichever comes first. These WC benefits may be reduced for wages received during the healing period, and the amount of WC payable is sometimes recalculated every 2 weeks.

Pennsylvania law allows future periodic payments to be commuted by the WC Board. When the period to be commuted is 52 weeks or less, no discount is allowed. When more than 52 weeks are being commuted the lump sum is usually calculated at a discounted rate. For information on prorating Commuted Awards, see DI 52150.065B.

The WC Act permits employers and injured workers to settle claims for WC benefits, including medical expense benefits. Life expectancy lump sum settlements are prevalent in Pennsylvania. For information on life expectancy lump sum settlements, see DI 52150.065.

A Compromise and Release Agreement, form LIBC-755, is required and must be approved before the agreement is legally binding. The form itself is detailed and generally provides all the information needed to impose offset, but sometimes the effective date of the award is not specified. This is problematic when periodic payments were made but their end date is not shown in the award. However, C&R agreements are signed on the day of the hearing, right before being submitted to the judge for approval and the date the C&R was signed is the last date periodic payments were due. If the body of the C&R does not specify an effective date, use the day after the day it was signed as the lump sum proration effective date.

CAUTION: Disregard any subsequent addendums regarding how to prorate the award. If an addendum was made at the same time as the award, it will generally be referred to in the award. If there is no reference to the addendum in the award, the employer/carrier can be contacted to verify whether the addendum was part of the original settlement. For more information on Subsequent Addenda to LS Settlements, see DI 52150.065.

This Act applies to all public law enforcement officers and investigators, firemen, park guards, etc. who were injured in the performance of their duties. These benefits are available for any temporary incapacity which results from a work injury. Individuals permanently incapacitated from returning to their pre-injury duties are ineligible for Heart and Lung Act benefits.

These benefits apply to certain employees of State penal and correctional institutions, mental hospitals, and others who are injured at work. The injured individual is entitled to receive their salary until they are able to return to work for his employer at a salary equal to that earned at the time of the injury.

Pennsylvania reduces its WC payments for 50 percent of RIB received, if the WC injury occurred 06/24/1996 or later, and if the entitlement to RIB did not begin prior to the date of the injury. Advise claimants to contact the Pennsylvania Bureau of Workers Compensation to determine how this offset provision would impact their WC payments if they elect RIB. The offset is described in Pennsylvania Regulations Chapter 123.7. We do not curtail development of a RIB election at age 62 for Pennsylvania WC cases.

Unless the individual gives notice to the employer within 21 days of the injury (or the employer had knowledge of the injury), no WC is payable before the date notice is given. For any compensation to be allowed, notice must be given within 120 days of the injury.

If the request for WC benefits was denied or WC benefits were paid but then stopped, the individual has 3 years from the date of injury to file a claim petition or petition to reinstate WC benefits.

The injury/disability must occur within 300 weeks from the date of last employment in an occupation in which the individual had exposure to a hazard, and a petition must be filed no later than 3 years from the date of injury/disability.

If WC benefits were terminated, a petition to reinstate WC benefits must be filed within 3 years after the date of the most recent WC check.

Our best source of information is usually the WC carrier. Carrier contact information can be obtained from the state. See the state link for contact information for Pennsylvania carriers under ‘REFERENCES’ in this section.

The Bureau of WC can be contacted for help in identifying the carrier.