Frequently Asked Questions about Workers Compensation in Pennsylvania
How does workers compensation work?
Workers’ compensation is a form of insurance that provides wage replacement and medical benefits to employees who are injured on the job. It is designed to protect both the employee and the employer by ensuring that injured workers receive compensation for their injuries and related expenses, while also protecting employers from costly lawsuits. Workers compensation laws in Pennsylvania require employers to provide benefits to employees who are injured at work, regardless of who was at fault for the injury.
Is there a waiting period for workers compensation disability benefits?
Yes. An employee must be disabled for 7 calendar days (including weekends) before workers compensation benefits are payable. Benefits for time lost from work are payable on the 8th day after the injury. Medical benefits are paid from the date of the injury.
Once an injured worker has been off work 14 days, they receive retroactive payment for the first 7 days. In other words, if you are off work 7 days or less, you are not entitled to receive workers compensation payments for disability.
Medical bills are covered. For example, if you are off work 10 days, you would be paid 3 days of disability benefits. However, if you are off 14 days or more, you will receive retroactive payments all the way back to the first day of disability.
Do the dates of disability have to be consecutive?
No. Days of disability do not have to be consecutive. In other words, you can accumulate disability days when applying the 14-day rule above. For instance, if you miss 3 days then return to work for 3 weeks then miss another 3 days, and return to work for another period of time, you can accumulate the days.
If a total of 14 days or more are accumulated, you would be entitled to receive compensation benefits for the entire period that you missed work. The key here is that the injured employee should report each period of disability so that the employer knows that each absence is work-related. In other words, if you miss a day of work because of a work injury, you should make sure that your employer knows that you are reporting off work because of the injury and not because of an illness that could be interpreted as being non-work related.
Who pays for workers compensation?
Employers must either be certified by the State as a self-insured entity or pay for workers’ compensation insurance to cover costs associated with work-related injuries or illnesses in Pennsylvania.
Who pays your health insurance while on workers’ compensation?
This can vary from employer to employer. If you have health insurance through your employer it may continue under the same terms as when you were working, but it also could become your responsibility. If you are in a union the collective bargaining agreement may set forth how long your employer will pay your health insurance. Your employer may have a policy about continuing the health insurance also. Workers’ compensation laws themselves do not require a continuation of health insurance.
How much does workers compensation insurance cost?
The cost of workers’ compensation insurance varies based on factors like the type of work, number of employees, and claims history. Generally, rates range from 75 cents to $2 per $100 of payroll. It’s recommended to get quotes from different insurance providers to find the best option for your specific needs.
If I miss work for 5 days because I am disabled, then return to work on light duty at a lesser wage, can I get paid for the 5 days of total disability?
Yes. Periods of total and partial disability are counted toward the 14-day requirement. According to the law, there is no reason to distinguish between total and partial disability.
What happens if I am injured on the job and return to work immediately on light duty, but receive a partial disability payment? Does partial disability count toward the 14-day disability requirement?
Yes. Even if you return to work immediately after your injury, so long as you are receiving partial disability benefits, these days will count toward the 14-day requirement.
Do you receive a 1099 for workers’ compensation?
No, you do not receive a 1099 for workers’ compensation.
Is workers compensation taxable?
Workers’ compensation is usually not taxable at the federal level in Pennsylvania. This means that you do not have to report workers’ compensation benefits as income on your federal tax return.
Can I be terminated while on workers compensation?
Yes, it is possible to be terminated while on workers’ compensation in Pennsylvania, but the reasoning behind the termination must not be related to the workers’ compensation claim itself.
What about pain and suffering? Can I recover for this?
No. Again, the only recovery that you can obtain under the Workers Compensation Act is workers compensation. This includes weekly payments for your lost wages, loss of use, or disfigurement.
In addition, you can recover medical expenses associated with the treatment of your injury. If you are killed on the job and are survived by a spouse and children, your family can recover death benefits. Otherwise, you are not permitted to recover any other type of consequential damages from your employer.
My neighbor was injured in a work-related accident and he received a large judgment against the manufacturer of the machine that caused him to be injured at work. I thought you said you could not sue under workers compensation.
You are not permitted to sue your employer under workers compensation for pain and suffering or consequential damages. However, workers who are injured by a third party (such as the manufacturer of a machine or some other tool that malfunctioned at work) are subject to a civil action.
These types of cases are frequently referred to as third-party claims. If, for example, you are working on the job and a large piece of machinery malfunctions, causing you to be injured, you may have a cause of action against the manufacturer of the machine. However, to do so, it must be established that your employer did not do anything to alter the machine, such as removing safety guards or other protective devices. There are many instances where an injured worker can in fact recover from a third party.
Does a workers compensation settlement affect social security disability?
Yes, a worker’s compensation settlement can impact Social Security Disability benefits. The settlement amount may affect the SSDI payment amount received. There are ways an experienced workers’ compensation attorney can help you reduce or even eliminate the reduction.
How long does it take for a workers compensation settlement?
A workers’ compensation settlement timeline can vary depending on the specific circumstances of the case. It may take anywhere from a few weeks to several months to reach a settlement, as it depends on factors like the complexity of the case, negotiations involved, and legal processes.
Who should I contact with any additional Workers Compensation FAQs?
Our experienced workers compensation law attorneys are here to help. Contact YCL Law Group directly for answers to any additional Pennsylvania Workers Compensation questions.