Many individuals fail to realize that if they are injured in the course of their employment, insurance coverage is almost always available to pay for their lost wages and medical expenses. This type of insurance is what is known as workers’ compensation, and must be provided by most employers under Pennsylvania’s Workers’ Compensation Law.
The premium for workers’ compensation insurance is paid by the employer, not by the employee. This is one reason some people fail to realize that this type of insurance coverage is available.
Pursuant to the Workers’ Compensation Law, if an employee is hurt at work, workers’ compensation insurance will typically pay the employee two-thirds of his ongoing lost wages.
For example, if the employee is entirely off work because of his injury, the worker will generally receive two-thirds of his full pre-injury wage. On the other hand, if the injured employee is capable of working, but because of his injury cannot earn a wage equal to his pre-injury wage, the worker will receive two-thirds of the difference between his pre-injury wage and his ongoing post-injury wage.
For 2016, the maximum amount which can be paid for lost wage benefits is $978.00 per week. One the other hand, if you are a low-wage earner, there is minimum rate that can be paid, which is $489 per week. However, if you earned less than $543 per week, your workers’ compensation benefits will be paid at a full 90 percent of your pre-injury wages.
The pre-injury wage which is utilized to calculate workers’ compensation wage benefits is the worker’s gross wage, not his net wage. If the worker’s pre-injury wage was a fluctuating wage, the law requires that an average pre-injury wage be determined from wages earned prior to the injury.
Obviously, if a healthy individual is injured at work, he is entitled to workers’ compensation benefits. However, few workers realize that they are also entitled to workers’ compensation if their work causes an aggravation of a preexisting, non-work related, injury or medical condition.
For example, if an individual has a back problem that is not work related, he is entitled to workers’ compensation benefits if his work aggravates his back condition to the point where it interferes with his ability to work.
In addition to injuries, workers’ compensation benefits are also available to workers who contract a disease as a result of their work environment. For example, if a worker suffers asbestosis as a result of his exposure to asbestos at work, he is entitled to workers’ compensation benefits.
The duration of workers’ compensation benefits is unlimited if the worker is completely unable to work as a result of his work related injury or disease. However, if the worker’s earning capacity is only partially decreased as a result of his work related injury, he can only receive workers’ compensation wage benefits for a maximum of 500 weeks.
In addition to benefits for lost wages and medical expenses, our Workers’ Compensation Law also provides for the payment of fixed sums for the loss of body parts, such as arms, fingers, toes, legs, feet, etc. Payment is also available for scarring or disfigurement to the head, neck and face, including loss of teeth. In these type of cases, lost wages do not need to be demonstrated. For example, if the worker loses a finger, but does not lose time from work, he is still entitled to a fixed amount of compensation for the loss of his finger.
In the event of death from a work related injury or a compensable disease, our Workers’ Compensation Law also provides for the payment of a death benefit in most cases.
Importantly, keep in mind that a worker must give his employer timely notice of his work related injury in order to receive workers’ compensation benefits. This notice must be given within 120 days after reasonably learning of the work related nature of the injury. If this notice has been given, the worker is allowed to file a claim for benefits at any time within three years after the date of the injury, except in the case of eye injuries in which event there may be an unlimited time to file a claim.
Ed Coyle is an attorney with the Buzgon Davis Law Offices. His column appears in the Lebanon Daily news on the first Tuesday of each month.