Most Pennsylvania workers have access to workers’ compensation coverage following an on-the-job injury or work-related illness. Under the Pennsylvania Workers’ Compensation Act, employers must provide these benefits to all employees from the first day they report to work. These benefits are available because the law prevents the worker from taking legal action against their employer.
There are several different types of workers’ compensation benefits. If an employee suffers an injury or develops an illness at work, workers’ compensation in Pennsylvania will cover the cost of their care. If they miss work because of it, they should also be able to claim additional benefits. This includes wage loss benefits based on their ability to work as well as specific loss benefits and death benefits.
Medical Care Benefits
No matter if you miss work or not, your workers’ compensation insurance should cover treatment for any injury you sustain or illness you have because of your job. This includes all necessary and related care, from the ambulance ride to the hospital to hospitalization to follow-up care. Your workers’ compensation insurer should cover all costs. There is no balance billing on these expenses. They cannot bill you for anything not covered.
In addition to hospital treatment and services, this benefit includes:
- Prescription medications
- Walk-in clinic treatment
- Emergency department treatment
- Rehabilitation and therapy
- Orthopedic appliances or prosthesis
- Necessary mobility equipment
- Other medical devices
Payments for Lost Wages
At the heart of any workers’ compensation plan is the wage-loss benefits for employees whose injury or illness keeps them away from work. In Pennsylvania, there are two different types of disability benefits associated with workers’ compensation wage loss:
Temporary Total Disability Benefits
Temporary Total Disability benefits are available for at least the first 104 weeks (two years) that you cannot work because of your job-related injury or illness. If your doctor cannot approve you to return to work after two years, the workers’ compensation insurance provider may require you submit to an Impairment Rating Evaluation (IRE). You need to show you have more than 35 percent whole body impairment to keep these benefits.
Partial Disability Benefits
If an IRE shows you have less than a 35 percent whole body impairment or if your doctor says you can perform light-duty work, you may begin to draw partial disability benefits. If you return to work on “light duty,” you may earn less than you did previously. Your partial disability benefits will pay two-thirds of the difference between your previous job and your current job, up to a maximum payout amount.
Specific Loss Benefits
Specific loss benefits pay out a lump sum award to workers whose injuries caused them to lose a body part, lose the use of a body part, or lose a specific body function. Some of the types of injuries that might make this benefit possible in your case include:
Amputation or loss of use of a:
- Thumb or finger
You might also qualify if you suffered:
- Loss of vision
- Loss of hearing
- Permanent disfigurement on your head, face or neck
- Traumatic brain injury
We can review your case for you to ensure you get the benefits you deserve. If the workers’ compensation insurance company tries to negotiate a settlement with you, reach out to our team, and we can handle it at no out-of-pocket cost to you.
If a worker gets hurt or sick because of something that happens on their Pennsylvania job site and passes away as a result, their employer’s workers’ compensation insurer should pay out death benefits to the worker’s dependent survivors. These benefits include cash to help them cover reasonable funeral and burial expenses, weekly lost wage benefits for their spouse and/or minor children, as well as other benefits.
How long these benefits last and how much you receive will depend on the facts of your case. We can review your case and ensure you are getting the benefits your family deserves during this difficult time.
Berger and Green Can Help You Fight for the PA Workers’ Compensation You Deserve
At Berger and Green, our Pittsburgh workers’ compensation attorneys can help you understand your rights and fight for the benefits you deserve after an on-the-job injury or illness. We may also be able to help you prepare your application for Social Security Disability benefits if you suffer a long-term impairment and qualify for benefits.
If your employer or the workers’ comp insurance company denies your claim or denies your injuries occurred at work, our team is here for you. We can appeal your denial and ensure you understand your options for getting the money you need. Call us today at 412-661-1400 to get started with a free case review.