Wage Loss Benefits

January 17, 2025

PA Bureau of Workers’ Compensation Creates Form for Direct Deposit

As we previously mentioned on our Blog, Senate Bill 1232 was created to require insurance carriers to offer direct deposit of PA workers’ compensation benefits to injured workers across the State of Pennsylvania. Hopefully, this will allay the difficulties that many injured workers have with receiving their workers’ comp checks by regular mail. Governor Josh Shapiro signed Act 126 of 2024 (as SB 1232 became) into law on October 29, 2024.

By the terms of Act 126, insurer carriers (and self-insured employers) have one year to offer the payment of workers’ compensation benefits by direct deposit (so, by October 29, 2025). Failure of the insurer to offer direct deposit beyond that date would likely be considered a violation of the Pennsylvania Workers’ Compensation Act, punishable by an award of penalties.

Act 126 discusses the creation of a form, which would be completed by the injured worker to start, stop or change the direct deposit. Recently, the Pennsylvania Bureau of Workers’ Compensation released the first version of this form (LIBC-215).

January 10, 2025

PA Injured Worker Unable to Add Medical Condition Related to Accepted Work Injury

by Glenn Neiman

As we have discussed in this blog previously, changes to an accepted work injury in PA come in two types – “corrective” and “consequential.” The difference between these two situations can make or break a case, as recently illustrated by the Commonwealth Court of Pennsylvania in their decision in the Grow v. PECO Energy Company (Workers’ Compensation Appeal Board) matter.

A “corrective” amendment is when the condition was present at the time of the work injury. In this situation, the injured worker need not file a Petition to Review, and the corrective amendment can be made by a Workers’ Compensation Judge (WCJ) in the litigation of any type of petition. A “consequential” amendment, however, requires the filing of a Petition to Review. This is used when the new condition is due to the accepted work injury, but takes place after the time of the injury (ie: as a consequence of that injury). Significantly, a Petition to Review can only be filed within three years of the date of the last payment of workers’ compensation benefits.

Looking at the Grow case, the injured worker hurt his neck while working on November 4, 2013. The injury was accepted by the workers’ comp insurance carrier, using a Notice of Compensation Payable (NCP), which described the work injury as “contusions and fractures at C3-C4.” As a result of the work injury, disc fusion surgery was performed. To his credit, the injured worker went back to work on January 10, 2014, and the workers’ comp benefits were suspended.

October 11, 2024

Direct Deposit for PA Workers’ Compensation Benefits Moves a Step Closer

by Glenn Neiman

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.

January 4, 2024

PA Workers’ Compensation Maximum Rate for 2024 Announced

by Glenn Neiman

The Pennsylvania Bureau of Workers’ Compensation has released the maximum workers’ compensation rate for injuries suffered in 2024. This is based upon the statewide average weekly wage. For injuries suffered in 2024, the maximum workers’ comp rate will be $1,325.00 per week. This is up from the 2023 maximum rate of $1,273.00.

As with have noted in previous blogs, the rate in effect at the time of the injury is the rate which will remain for that case permanently. Unlike other benefit programs, like Social Security, there is no annual increase for existing injuries, such as cost of living adjustments.

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. 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.

June 8, 2023

Specific Loss Benefits Awarded Under PA Workers’ Compensation Not Always Paid

by Glenn Neiman

There are several types of benefits which can be received by an injured worker in Pennsylvania. A comprehensive review of these benefits can be seen here on our website. One of those benefits is called “specific loss,” which contains things like loss of use of a body part and disfigurement of the head, face or neck (though House Bill 930 could expand disfigurement beyond the head, face or neck).

Importantly, specific loss benefits cannot be received while the injured worker is still receiving “temporary total disability” benefits (essentially, what we call total wage loss benefits). Again, at least as far as disfigurement, this could change with House Bill 930.

What if the injured worker dies before the temporary total disability benefits stop? Surely, the specific loss benefits, since already “awarded” would be paid to the estate, right? Nope, wrong. The full answer is that it depends what caused the death of the injured worker.

December 2, 2021

Maximum Workers’ Compensation Rate for PA in 2022 Will Be $1,205.00

by Glenn Neiman

The Pennsylvania Department of Labor & Industry recently announced that the “statewide average weekly wage” (SAWW) for 2022 will be $1,205.00. This represents a 6.6% increase over the SAWW for 2021 of $1,130.00. Under the PA Workers’ Compensation Act, the SAWW represents the maximum workers’ compensation rate which can be received by an injured worker in Pennsylvania.

December 17, 2019

PA Workers’ Compensation Maximum Rate Raised to $1,081.00 for 2020

by Glenn Neiman

As we have mentioned in the past, unlike Social Security Disability benefits, PA workers’ comp benefits have no cost-of-living increase. However, the maximum rate of workers’ compensation benefit that an injured worker can receive does increase annually. Unfortunately, this only affects injuries taking place in the new calendar year. The Pennsylvania Bureau of Workers’ Compensation has announced that the maximum workers’ compensation rate for injuries taking place in 2020 will be $1,081.00. This is increased from the maximum rate for 2019 of $1,049.00.

The Pennsylvania Workers’ Compensation Act sets forth the procedure for the calculation of the Average Weekly Wage (AWW). From this figure, we determine the temporary total disability rate, often just referred to as the workers’ compensation rate. Depending on the figures, the workers’ compensation rate is usually 2/3 of the AWW, though that is just the general rule. Mid-range AWW can result in a workers’ compensation rate of half of the maximum rate. A lower AWW can lead to a workers’ compensation rate at 90% of the AWW. On the other hand, an injured worker earning a very high wage would create a workers’ compensation rate limited by the maximum compensation rate, which would mean he or she would receive less than 2/3 of the AWW.

This can be a complicated area in the PA workers’ comp system, both through the calculation of the AWW and the workers’ compensation rate, as well as what can be included within the AWW calculation. Insurance carriers frequently make mistakes in these calculations (yet, rarely are these “mistakes” to the benefit of the injured worker).

November 1, 2018

Act 111 Brings Back IRE to PA Workers’ Compensation

by Glenn Neiman

We have been following the status of the Impairment Rating Evaluation (IRE) process in PA closely, ever since the Supreme Court of Pennsylvania declared the IRE process unconstitutional in Protz v. Workers’ Compensation Appeal Board (Derry Area School District). This has included interpretations by the Commonwealth Court of PA in the Whitfield and Timcho cases.

As we long suspected, though, the real response would come from the Pennsylvania legislature. In their ever-present desire to bend to the wishes and desires of the insurance industry, the legislature passed Act 111 (formerly known as House Bill 1840). This was signed into law by Governor Thomas Wolf on October 24, 2018. This immediately reinstates the IRE aspect of the Pennsylvania Workers’ Compensation Act.

Since we have previously discussed what the IRE process involves, we will not again detail that information. If you would like to see more of that discussion, we would suggest reviewing the prior blog entries regarding the Protz, Whitfield and Timcho cases.

November 3, 2017

Settling a PA Workers’ Compensation Case

by Glenn Neiman

One of the frequent questions we are asked is regarding the settlement of a Pennsylvania workers’ compensation claim. In fact, there is a page on our website just devoted to settlements. When considering whether to settle his or her case, there are several things an injured worker should consider. Initially, it is important to note that not every workers’ comp case settles. Workers’ compensation benefits can end for a variety of reasons, other than a settlement. Therefore, just because you have had a work injury in PA, do not believe you are simply entitled to a settlement.

The timing of the case is always an important consideration when considering whether to settle a case. We do not mean timing in a strict calendar sense, as there is no magic number of months or years which must go by before a case can settle. Instead, we are looking at the posture of the case. Is the injured worker still in active treatment? Is surgery, or other invasive treatment still being planned? Is there other health coverage available? As to the case legally, we ask whether there is a current threat to the benefits? Whether there is current litigation, and the chances of success? What is the employability of the injured worker? (Considering that encompasses both physical restrictions, as well as educational and work backgrounds). As you can see, there are many factors going into whether now is the right time to settle.

Next, the question may be the value of the case. Again, there is no magic formula. A settlement only works if both sides agree. It has to be voluntary for everyone. Unlike a personal injury case, there is no pain and suffering in a PA workers’ compensation case. A settlement purely reflects loss of earnings, and, if applicable, future medical treatment. Obviously, the settlement figure is something to be negotiated.

June 4, 2008

PA Injured Worker Can Lose Workers’ Comp Benefits When Receiving a Notice

by Glenn Neiman

Many injured workers in Pennsylvania know not to sign a document they receive from the workers’ compensation insurance company without checking first with an experienced workers’ compensation attorney. Unfortunately, few injured workers are aware that some documents exist in the Pennsylvania Workers’ Compensation Act which can cause workers’ comp benefits to be reduced, or stopped, even if the documents are NOT signed by the injured worker.

When an injured worker returns to work in PA, he or she is still entitled to workers’ compensation benefits if there is still a loss in earnings (maybe the modified job pays less per hour, or offers fewer hours). The workers’ compensation insurance company must take some action if it wishes to reduce, or stop, weekly compensation benefits. In the old days, the workers’ compensation insurance company would have to file a Petition for Modification or Suspension, and litigate the issue. This is no longer the case.

These days, the workers’ compensation insurance company can simply file a Notification of Modification or Suspension, which contains an affidavit that the injured worker has returned to work, whether at pre-injury or reduced wages. If the Notification of Modification or Suspension is not “challenged” (appealed) by the injured worker, the Notification of Modification or Suspension has the same legal effect as if the injured worker signed a Supplemental Agreement, agreeing that the injured worker did return to work at those wages.