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After months of rumor, the Pennsylvania Bureau of Workers’ Compensation has made it official – there is a new Director of Adjudication.  The Honorable Holly San Angelo will take over the position.  Formerly acting as a Workers’ Compensation Judge (WCJ) in the Philadelphia Workers’ Compensation Hearing Office, and then a stint as Southeastern District Judge Manager, Ms. San Angelo brings a great deal of experience to the position.

The previous Director of Adjudication, Joseph DeRita, will go back to his prior position as WCJ in the Malvern (Montgomery County) Workers’ Compensation Hearing Office.  Practitioners on both sides of the aisle owe a huge debt of gratitude to Mr. DeRita for his masterful handling of the PA workers’ comp system during and after COVID wreaked havoc on the entire legal world.

Given his admirable handling of the Pennsylvania workers’ comp system, Mr. DeRita has left big shoes for Ms. San Angelo to fill.  But, knowing Ms. San Angelo as a practicing attorney, sitting Judge, and Judge Manager, we have complete faith in her ability to steer the ship toward continued success.

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Today, we received notice from the Pennsylvania Bureau of Workers’ Compensation stating that the maximum workers’ compensation rate for injuries suffered in 2025 will be $1,347.00.  This number is based upon the Statewide Average Weekly Wage (SAWW).  This figure is an increase from the SAWW of $1,325.00, which represented the maximum workers’ compensation rate for 2024 injuries.

Unfortunately, there is no annual increase for work injuries which have already taken place.  Other benefit programs, such as Social Security Disability, contain cost of living raises annually.  This is not present within the Pennsylvania Workers’ Compensation Act.  The benefit rate in effect at the time of the work injury is the rate which will remain for that case permanently.

The grid to see the calculation of the workers’ compensation rate from the Average Weekly Wage (AWW) can be found on the website of the Bureau of Workers’ Compensation (though, at the time of this blog, the site is not updated for 2025).  While the calculation of the rate from the AWW is purely mathematical, the calculation of the AWW itself is complicated and should always be checked by an attorney experienced in PA workers’ compensation.

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While perhaps not of interest to every injured worker, the subject of PA Department of Human Services’ (DHS) liens is one that appears from time to time in Pennsylvania workers’ compensation cases.  And, while the injured workers may not have a huge interest, the PA workers’ compensation insurance companies surely feel otherwise.  The topic can easily (as in the case we will discuss) feature bills of over $100,000.

In the case we will be addressing (Dura-Bond Coating, Inc. v. R. Marshall & PI&I Motor Express (WCAB)), the injured worker suffered a catastrophic work injury, leading to the amputation of both of his legs.  Given that there was a dispute as to what entity was actually his “employer,” there was considerable litigation following the filing of a Claim Petition.

While the Claim Petition was being litigated, medical bills were not being paid by any workers’ compensation insurance carrier.  This resulted in bills being paid through DHS.  In a situation like this, where DHS pays for treatment that should be borne by another party, DHS has a lien to recover payments it has made.

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Pennsylvania workers’ comp unfairly treats mental or psychological injuries differently than physical ones.  Our system is a “no-fault” structure.  What does that mean?  Put simply, if an employee is doing his or her job, and suffers a disabling physical injury, he or she is generally entitled to PA workers’ compensation benefits.

It usually does not matter why the injured worker was hurt, though the injured worker had to be engaged in an activity less foolish than swinging a sledgehammer at a bowling ball, or recreationally leaping down a flight of stairs.  Mental or psychological injuries, however, are treated by a different standard.  As a general rule, mental or psychological injuries have to be suffered as a result of “abnormal working conditions.”

There is an entire string of cases, as you might imagine, addressing what constitutes “abnormal working conditions.”  This varies by the job one is doing, so first responders, such as police officers, fire fighters and EMTs, had a very high burden to prove something they encounter on the job is “abnormal.”  Establishing Post-Traumatic Stress Disorder (PTSD) for a first responder was a difficult battle.

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One of the bigger “victories” by the PA workers’ compensation insurance industry against the injured workers in Pennsylvania is the Impairment Rating Evaluation (IRE) process. Under this process, after an injured worker has received 104 weeks of temporary total disability benefits, the insurance company can initiate an IRE, which can limit the period of time an injured worker can receive workers’ compensation benefits. The IRE process is covered in great detail on our website.

If the examining physician finds that the injured worker has less than a 35% “whole body impairment” due to the work injury, the benefits can shift from “total” in character to “partial.” This does not change the amount of the benefits the injured worker receives, but it limits the duration for which the injured worker can receive those benefits.

One of the questions in the IRE process is which conditions or diagnoses need to be considered by the IRE physician in calculating the “whole body impairment.” There was a school of thought, championed by the insurance industry, that the IRE could only consider those conditions or diagnoses actually accepted as work-related. Thankfully, the Commonwealth Court of Pennsylvania has provided some clarification, establishing that the IRE physician must consider all conditions or diagnoses “due to” the work injury, whether accepted or not.

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As attorneys who represent injured workers across the great State of Pennsylvania, we are all too aware that our clients who rely on the US Postal Service for the delivery of their workers’ compensation checks can occasionally find their checks lost or delayed in transit.  Since mortgage companies, landlords, car financers, grocery stores and other lenders do not want to hear about delays in the mail, injured workers too often have to deal with the stress of a late check on top of the stress they already feel from the work injury.

Fortunately, those times may be changing!  We just learned that Senate Bill 1232 passed the PA House unanimously, and will now move to the Senate for consideration.  Should this Bill become law, injured workers all across Pennsylvania would be able to have their workers’ compensation benefits delivered by direct deposit.

This will not stop the occasional “computer issue” which for some reason causes an injured worker to “fall off the system,” but at least it can stop the annoyance of not knowing whether the check was actually mailed or not.  We will also be aware of the issue sooner and can move to have it quickly resolved.

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Knee injuries are common in Pennsylvania workers’ compensation.  Over the years, we have had many clients with a torn meniscus in his or her knee.  This is generally regarded as a minor injury by the insurance industry, a perception we have never understood.

Recently, Minnesota Vikings Quarterback J.J. McCarthy injured his knee.  Further testing revealed a torn meniscus.  Note that the referenced article describes the meniscus as a “tendon,” though it is not.  The meniscus is a piece of cartilage in the knee.  Essentially, the meniscus functions as a cushion between the “tibia” (shin bone) and the “femur” (thigh bone).

Surgery is often required to address a meniscus tear, though it is not usually the first avenue to try (that said, Mr. McCarthy had the surgery immediately and will miss the entire 2024 season while recovering).  Typically, in our experience, an injured worker will receive conservative treatment initially, in an effort to avoid surgery.  If surgery is eventually required, this obviously extends the total period the injured worker may be out of work.

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The Pennsylvania Workers’ Compensation Act (“Act”) has several “offsets,” which provide a workers’ comp insurer with a credit for other types of benefits received by an injured worker, such as unemployment compensation, Social Security Retirement (“SSR”), severance and pension benefits. These offsets were created to avoid a perceived “double dipping” by an injured worker, getting paid (in theory) twice for one injury.

These offsets are set forth in Section 204(a) of the Act. Each of the benefits is treated differently. For example, with SSR, the workers’ compensation insurer is entitled to a credit of fifty percent of the SSR benefit, “Provided, however, [t]hat the Social Security offset shall not apply if old age Social Security benefits were received prior to the compensable injury.” On the other hand, “benefits from a pension plan to the extent funded by the employer directly liable for the payment of compensation which are received by an employe shall also be credited against the amount of the award.” Notably, there is no mention of a difference whether the pension benefits were received prior to the work injury. So, what happens if an individual retires, starts getting a pension and then is injured?

This situation was recently addressed by the Commonwealth Court of Pennsylvania in the case of Bradford County and PCOMP v. Pasko (Workers’ Compensation Appeal Board). Here, the injured worker (“Claimant”) was employed by Bradford County for 25 years, when he retired in 1993. Upon his retirement, Claimant began to receive an employer-funded pension.

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When we litigate cases in the Pennsylvania workers’ compensation system, we often resolve such matters through a Stipulation of Facts.  This agreement of the parties is then approved by a Workers’ Compensation Judge (WCJ) and has the same effect as any other decision of a WCJ.  This kind of resolution often can resolve disputes quickly and easily, saving the parties the time and effort of unnecessary litigation.

Once a Stipulation of Facts is approved by a WCJ, and the appeal period passes, it can no longer be disturbed.  Maybe. A recent decision by the Commonwealth Court of Pennsylvania addressed a situation where it was necessary to set aside a Stipulation of Facts after it was approved by a WCJ.

In VNA of St. Luke’s Home Health/Hospice, Inc. v. Elizabeth Ortiz (Workers’ Compensation Appeal Board), the injured worker hurt her left shoulder at work in 2017.  The workers’ comp insurer accepted the injury as a “left shoulder strain.”  Believing her injury was more significant than that accepted, the injured worker filed a Claim Petition (though it seems more in the nature of a Petition for Review), alleging additional diagnoses.  Based largely on the testimony of the injured worker, that there were no issues with the left shoulder before the 2017 work injury, and the medical records stating the same, a Stipulation of Facts was reached, expanding the work injury to include “a left rotator cuff tear and biceps tendon injury.”  The Stipulation of Facts was approved by a WCJ in 2019.

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No matter what kind of company one works for, as long as one is an “employee,” as defined in the Pennsylvania Workers’ Compensation Act (and not otherwise excluded by other laws, such as federal employees, military personnel, maritime workers and railroad workers), one is entitled to workers’ compensation benefits if an injury is suffered while at work. This is true whether one works for a sole proprietor, small corporation or a major international conglomerate.

When a work injury takes place in PA, notice is required to be given to the “employer” within 120 days of the injury. Failure to do so can result in the injured worker being barred from receiving any workers’ compensation benefits for the injury. This can get more complicated when we are dealing with a sole proprietorship or a small corporation, where the owner is the injured worker. To whom must this notice be provided?

The Commonwealth Court of Pennsylvania recently addressed this issue in Erie Insurance Property & Casualty Company v. Heater (Workers’ Compensation Appeal Board). In this case, the injured worker was the owner of a sole proprietorship. By definition, the “employer” had notice of the work injury as soon as the injured worker had the injury, since they are the same entity.

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Warminster, PA 18974
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