Worker Comp Generally

October 23, 2025

Abnormal Working Conditions Found For First Responder in PA Workers’ Comp Claim

As we have discussed previously on this blog, physical injuries in Pennsylvania are treated differently than mental ones. Provided that a physical injury was suffered in the scope and course of the job, benefits should be payable. Mental injuries, though, have a different and additional requirement – the injury must have resulted from “abnormal working conditions.”

There should not be much surprise, then, that many cases have dealt with whether a particular fact pattern reaches the standard of “abnormal working conditions.” This determination is very dependent on the exact facts of each case. And, of course, what would be expected in that particular job. What a police office, fire fighter or EMT might expect on a normal day at work is very different from that of an accountant, warehouse worker or a secretary.

Recently, the Commonwealth Court of Pennsylvania dealt with this issue in Ganley v. Upper Darby Township (Workers’ Compensation Appeal Board). Here, the injured worker was a firefighter/EMT, who was forced to perform CPR on infants twice in less than two years (with neither infant surviving). As a result of those events, the injured worker suffered post-traumatic stress disorder (PTSD).

August 20, 2025

PA WCJ Has Jurisdiction to Assess Penalties for Nonpayment of Medical Bills Related to Work Injury

by Glenn Neiman

The Pennsylvania Workers’ Compensation Act (Act) is very specific – a workers’ comp insurance carrier is responsible for the payment of all reasonable and necessary medical expenses, which are related to a work injury. As always, the devil is in the details. For example, is the payment of medical bills something which can only be addressed by Fee Review and not by a Workers’ Compensation Judge (WCJ)?

As the Commonwealth Court of Pennsylvania indicated in the recent case of Day-Timers, Inc. v. Rhonda Horton (Workers’ Compensation Appeal Board), a WCJ does, indeed, have jurisdiction to address the nonpayment of medical bills. But, initially, let’s examine the confusion.

Under the Act, a PA workers’ compensation insurer has 30 days to either pay a medical bill related to a work injury, or file for Utilization Review (UR), which challenges whether such treatment was reasonable and necessary. If a healthcare provider is not satisfied with the timing or amount of the payment for medical treatment, the provider has the ability to file for Fee Review. This statutory scheme could lead an insurance carrier to argue that an injured worker cannot file a Petition for Penalties, for the nonpayment of a medical bill, since that is a subject solely for Fee Review.

August 12, 2025

Amendment of PA Work-Related Injury Not Barred

by Glenn Neiman

Back in 2008, we discussed the decision of the Commonwealth Court of Pennsylvania in the matter of Weney v. Workers’ Compensation Appeal Board (Mac Sprinkler Systems, Inc.) [Note that the formatting, with the WCAB listed as the party and the Employer in parentheses, has been reversed since this decision]. This decision terrified attorneys who represent injured workers in Pennsylvania.

Essentially, Weney stood for the proposition that if a work injury is in litigation, and there is an aspect of the injury that was either raised, or should have been raised, the injured worker is barred from trying to bring it up in a subsequent litigation (what the court calls “technical res judicata”). The consequence of barring a condition from being added in the future, even if it was never even litigated in the past, is both a great fear and a terrible injustice to us in the workers’ comp Claimant bar.

However, the Commonwealth Court of Pennsylvania does recognize limits to this concept. This was addressed by the Court in the recent case of Michael N. Lewis, Sr. v. City of Philadelphia (Workers’ Compensation Appeal Board). The injured worker here was a police officer, who in 2017, sustained injuries to his hand/wrist, low back, chest wall, and thoracic spine while attempting to subdue a burglary suspect. The injury was properly accepted by issuance of a Notice of Compensation Payable (NCP).

May 15, 2025

PA Bureau of Workers’ Compensation Names Three New Workers’ Compensation Judges

by Glenn Neiman

We are excited to relay the news that the Pennsylvania Bureau of Workers’ Compensation, Office of Adjudication, has announced that there will be three new additions to the workers’ comp bench. Two will be serving the Philadelphia Workers’ Compensation Hearing Office and one will be in the Williamsport Workers’ Compensation Hearing Office.

Erica Burry, Esquire and Robert Rachlin, Esquire, will each begin training in June, 2025. Each will then be hearing cases in the Philadelphia hearing office. Meaning, Robert Rachlin, Esquire, will also begin his training in June, 2025, but will be assigned to preside over cases in the Williamsport hearing office.

We welcome these additions to the PA workers’ compensation bench, and wish them well in their careers as Workers’ Compensation Judges!

March 21, 2025

PA Supreme Court Upholds Coverage for all “Medicines and Supplies” Related to Work Injury

by Glenn Neiman

Back in November, 2023, we discussed the case of M.R. Schmidt v. Schmidt, Kirifides and Rassias, PC (Workers Compensation Appeal Board). As you may recall, this case addressed an issue regarding payment for CBD oil used in conjunction with treatment for a work-related injury. The Workers’ Compensation Judge (WCJ) ordered such bills paid, though the Workers’ Compensation Appeal Board (WCAB) reversed that decision. The Commonwealth Court of Pennsylvania then reversed the WCAB, determining that the initial decision authored by the WCJ was correct.

Since that time, the matter was appealed to the highest Court in the State, the Supreme Court of Pennsylvania. Recently, that Court issued an opinion which affirmed the decision of the Commonwealth Court of PA (saying the WCJ was correct in requiring coverage for the CBD oil).

The Court was very specific in its opinion, stating, “we hold that any item that is part of a health care provider’s treatment plan for a claimant’s work-related injury falls within the purview of the broad-encompassing phrase ‘medicines and supplies’ as provided in Section 306(f.1)(1)(i). We further hold that, in such circumstances, the cost containment provisions of the (Pennsylvania Workers’ Compensation Act) and the attendant Pennsylvania Department of Labor regulations, both of which apply to a health care provider, do not apply to a claimant.”

February 3, 2025

“Specific Loss” Benefits in PA Workers’ Compensation Has Higher Benefit Rate Than Total Disability

by Glenn Neiman

Workers’ compensation benefits in Pennsylvania consist of three types (aside from fatal claim benefits, which are not really relevant for this discussion). These are described in detail on our website. There are wage loss benefits (also known as “indemnity”), medical benefits and “specific loss” benefits. Specific loss benefits are paid for permanent loss of use of a body part and/or disfigurement claims (usually scarring, either from the injury or resultant surgery). The rate paid to an injured worker in wage loss benefits and specific loss benefits, for many years, has been calculated using the same formula. A recent decision by the Supreme Court of Pennsylvania has now overruled existing case law, changing the formula in specific loss cases.

Under Section 306(a) of the Pennsylvania Workers’ Compensation Act (Act), the rate for temporary total disability (TTD) benefits is calculated using the Average Weekly Wage (AWW) of the injured worker. The benefit rate is two-thirds of the AWW, up to the statutory maximum (which is set every year). If the benefit rate as calculated is less than half of the maximum rate, then the appropriate benefit rate is the lesser of 1) One half of the maximum rate; or, 2) 90% of the AWW. Note that the AWW and benefit rate are often miscalculated by the workers’ comp insurance carrier and should always be reviewed by an experienced workers’ compensation attorney. Under old case law, the same benefit rate paid for TTD was used for specific loss.

That all changed when the Supreme Court of Pennsylvania issued a decision in the case of Jackiw v. Soft Pretzel Franchise (Workers’’ Compensation Appeal Board). The language in the Act for specific loss benefits, in Section 306(c), says that the benefit rate for specific loss, “ . . . shall not be more than the maximum compensation payable nor less than fifty per centum of the maximum compensation payable per week for total disability as provided in subsection (a) of this section, but in no event more than the Statewide average weekly wage.” The reference there to Section 306(a) is what created the prior case law, saying the rate was the same for each type of benefit.

January 17, 2025

PA Bureau of Workers’ Compensation Creates Form for Direct Deposit

by Glenn Neiman

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.

December 4, 2024

PA Bureau of Workers’ Compensation Announces Maximum Rate for 2025

by Glenn Neiman

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.

November 22, 2024

DHS Lien Not Automatically Reimbursable Under PA Workers’ Comp

by Glenn Neiman

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.