You’re injured, and now you can’t work. How will you pay your rent, mortgage, car note, and other bills? Will you be able to afford groceries and keep the lights on? And if you were injured on the job, do you know how workers’ comp pays for lost wages in Pennsylvania?
We know this is a scary time in your life, but we want to make things easier. At Stapp Law, LLC we strive to answer every question our clients bring us with transparency and honesty. We regularly tackle difficult topics, including how workers’ compensation pays for things like missed paychecks and related medical bills.
We’ve addressed some of this topic in the following blog, and we are also available to speak with injured workers at no cost.
In This Blog, We’ll Answer Questions Like…
- What types of benefits can I get for lost wages?
- How can I figure out what my pre-injury wage was?
- Am I covered by workers’ compensation in Pennsylvania?
Replacing Lost Wages With Workers’ Compensation Benefits
For some people, all it takes is a single lost paycheck to completely upend their lives. If you’ve been hurt in a workplace accident or have been diagnosed with an occupational illness, Pennsylvania workers’ compensation may provide wage replacement benefits.
These benefits can be broken down into four different categories:
Temporary Partial Disability Benefits
For workers with a disability rating of 35% or less who are no longer able to work in the same capacity, temporary partial disability (TPD) benefits replace a portion of lost wages. You can receive TPD benefits even if you are able to work after a workplace accident, injury, or illness.
These benefits replace two-thirds of the difference between pre- and post-injury wages.
Temporary Total Disability Benefits
When a worker is temporarily unable to return to work or perform any type of work following an injury, they are entitled to temporary total disability (TTD) benefits for wage replacement. These replace two-thirds of the victim’s average weekly wage prior to their injury and are paid for a period of up to 500 weeks.
Once a worker can return to work or has reached maximum medical improvement, the payment of these benefits will be concluded. If appropriate, an individual may then qualify for permanent partial disability or permanent total disability benefits.
Permanent Partial Disability Benefits
If a doctor determines that an injured worker is permanently disabled but at a rate that is less than 35%, they may qualify for permanent partial disability (PPD) benefits. PPD benefits are paid throughout the course of a person’s lifetime at the rate of 2/3 difference between their pre-injury and post-injury wages.
These benefits are only paid to those who have reached maximum medical improvement (MMI). This means that a person’s condition or disability is not expected to improve any more in the future. In other words, their disability (even if their disability rating is under 35%) is permanent.
Permanent Total Disability Benefits
Someone who is permanently and totally disabled may qualify to receive permanent total disability (PTD) benefits for the remainder of their lifetime. To qualify, a doctor must determine that an individual is 35% or more disabled. There must be virtually no expectation that the individual’s condition or disability will improve.
Recipients of PPD are typically eligible to continue receiving these benefits for the remainder of their lifetime. These benefits are 2/3 of the recipient’s average weekly wage prior to injury, although exceptions may apply if they are also receiving Social Security disability benefits at the same time.
Calculating Your Pre-Injury Average Weekly Wage
Correctly calculating your pre-injury average weekly wage (AWW) is a complex process that involves taking a variety of factors into account. AWW is calculated using your total gross wages that you previously earned, meaning your income before taxes, health care costs, and other deductions are taken out of your paycheck.
Your total gross wage includes:
- Regular compensation (whether hourly or salary)
- Overtime pay
- Paid time off (PTO)
- Bonuses
- Gratuities
- Commissions
All your wages for the year prior (52 weeks total) to your injury will be added together and then divided into four quarters made up of 13 weeks. Each quarter is then divided by 13 to determine the average weekly income for each quarter.
The three quarters in which your earnings were highest are combined and divided by three. This will determine the average weekly wage on which your workers’ compensation benefits will be based.
If you’ve worked at your current job for less than a year, we recommend that you work closely with an attorney to determine what AWW your benefits will be based on.
Limitations and Caps on Wage Replacement Benefits
The state of Pennsylvania places an artificial cap on workers’ compensation benefits by limiting compensation to no more than the average weekly wage for the state. As of Jan. 1, 2023, the average weekly wage for Pennsylvania is $1,273.
This means that if your personal average weekly wage exceeds the state average, you will not be able to recover the full 2/3 of your pre-wage injury. Instead, you will be limited to benefits based on the state average of $1,273.
The state average weekly wage is based on calculations performed by the Department of Labor and Industry.
Do You Qualify for Workers’ Compensation?
The vast majority of employers in Pennsylvania are required to purchase and maintain workers’ compensation insurance coverage. The only requirement is that the employer must have at least one employee, although sole proprietors are exempted from this coverage.
Your coverage begins the very first day you start work. There is no waiting or trial period that you must complete in order to qualify for workers’ compensation benefits. This means that if you are injured in the first few days, weeks, or months of your employment, you are still eligible to receive benefits—even if your employer tries to claim that you aren’t.
Replacing Lost Wages After a Work Injury
If you were injured while on the job, you may be entitled to workers’ compensation benefits that replace a portion of your lost wages. Unfortunately, many injured and sick workers are initially denied the benefits they need.
At Stapp Law, LLC, we are familiar with all the tricks and tactics that employers and insurers use to deny reasonable claims. So whether you’re about to file for the first time or are considering an appeal, we’re here to help. Please contact us today so that we can match you with a workers’ compensation lawyer at our Williamsport office for a free consultation.
