How Benefits Are Paid for Workers’ Compensation
Posted On behalf of Schmidt Kramer on Apr 05, 2018 in Workers' Compensation
The Pennsylvania Workers’ Compensation Act provides for medical expenses and wage loss payments if you cannot work due to an occupational illness or injury. These payments are generally made by private insurance companies.
If you were injured while on the job or developed an illness because of your line of work, it is important that you understand Pennsylvania’s workers’ compensation laws and know which benefits you may be entitled to receive.
The workers’ compensation attorneys at Schmidt Kramer can carefully review your claim to determine if you are entitled to workers’ compensation and for what amount. We can discuss your legal options during a free, no-obligation consultation.
Call us today at (888) 476-0807 to schedule a consultation with a member of our legal team.
How Much Are Wage Loss Payments?
Wage loss payments are made if the workers’ compensation carrier determines that you are unable to work or are earning wages that are lower than your pre-injury earnings. This includes the following types of benefits:
Total Disability Benefits
Total disability benefits are paid to workers who are considered completely disabled and unable to work.
- These benefits are equal to two-thirds of your average weekly wage.
- If your average weekly wage is $569.43 or less in 2018, the minimum amount of benefits you will receive is equal to 90 percent of your average weekly wage or 50 percent of the statewide average weekly wage, whichever is lower.
- This benefit cannot exceed the average weekly wage as established by state law, which is $1,025 for injuries that occurred on or after January 1, 2018.
- The average weekly wage is subject to a three-percent increase each year.
Partial Disability Benefits
Partial disability benefits are paid if you are able to return to work but your earnings are less than they were before your injury.
These benefits are equal to two-thirds of the difference between your pre-injury earnings and your post-injury earnings. These benefits are common when a worker is sent to a different job or department with work-related restrictions.
How Is Your Average Weekly Wage Calculated?
Because your benefits are based on your average weekly wage, it is important that the calculation of this amount is as accurate and as high as possible. The amount of your workers’ compensation benefit is typically based on your earnings for the 12 months immediately prior to your accident.
Your average weekly wage includes all of the following sources of income and benefits:
- Vacation pay
- Holiday pay
- Profit sharing
- Incentive pay
- Sickness and accident benefits
Other factors may also affect your average weekly wage amount, such as:
- Working for two or more employers at the same time
- A previous injury
- The length of time you were working for the company before the injury
When Are Wage Loss Payments Made?
If you were injured at work, you must be disabled for more than seven consecutive days before wage loss payments are made. Benefits are payable on the eighth day following the injury.
If you are not able to work for 14 or more consecutive days, you will receive retroactive wage loss payments for the first seven days.
If you promptly report the injury and the workers’ compensation insurance carrier accepts the claim, you should receive the first compensation payment within 21 days from your absence from work. You will then regularly receive compensation payments.
When Do Wage Loss Payments Stop?
An employer or workers’ compensation carrier can stop paying workers’ compensation benefits if it learns that the worker has returned to work and is earning at least as much as he or she was earning before the injury.
- The employer may pay temporary compensation benefits for up to 90 days while a decision is pending, but it may notify the worker that it is stopping these benefits if the claim is not accepted.
- Partial disability benefits end after 500 weeks (about 9 1/2 years).
- If a person has a disability rating of 50 percent or greater and receives total disability benefits, these benefits may continue for the rest of his or her life.
How Can I Get Help for My Workers’ Compensation Claim?
The workers’ compensation attorneys at Schmidt Kramer fully understand the Pennsylvania workers’ compensation system. We know the reporting deadlines and the factors that affect your average weekly wage, and we will work diligently to help ensure that you receive the maximum workers’ compensation benefits.
Contact us today to schedule a free consultation. We work on a contingency fee basis, meaning that you do not pay us for our services unless we help you receive compensation.