Workers’ compensation laws vary among the various states but are fundamentally similar in that they protect persons who are injured on the job. In Pennsylvania, the Workers’ Compensation Act, or Act, provides for the payment of medical expenses and, in the event an employee is unable to work, wage-loss compensation benefits are paid. Death benefits for work-related deaths are paid to an employee’s dependent survivors. Although workers’ compensation in Pennsylvania is a “no fault” system that does not require proof of negligence on the part of the employer, the laws are complicated. No compensation is paid to an employee paid when an injury or death is intentionally self-inflicted, or is caused by an employee’s violation of the law including, but not limited to, the illegal use of drugs. An injury or death caused by intoxication also may not be covered.
Nearly every Pennsylvania worker is covered by the Act and begins on the date of hire. Employers must provide workers’ compensation (WC) coverage for all of their employees, including seasonal and part-time workers. Nonprofit corporations, unincorporated businesses and even employers with only one employee must comply with the Act’s requirements.
Some employees are covered by other compensation laws, including: federal civilian employees, railroad workers, longshoremen, shipyard and harbor workers. Others who may not be covered include volunteer workers, agricultural laborers, casual employees, domestics and employees who have been granted a personal religious exemption from the Act. Certain types of executive officers of corporations may elect exemption from the Act. A worker should always seek further information if there is any doubt as to coverage.
In the event of a work-related illness or injury, an employee is entitled, if covered under the Act, to the payment of related reasonable surgical and medical services rendered by a physician or other health care provider. Medicine, supplies, hospital treatment and services, orthopedic appliances and prostheses are also covered for as long as they are needed.
Wage Loss Benefits
Wage-loss benefits are available if the employee is totally disabled and unable to work or partially disabled and receiving wages less than their pre-injury earnings. In addition, if an employee has lost the permanent use of all or part of their thumb, finger, hand, arm, leg, foot, toe, sight, hearing or has a serious and permanent disfigurement on their head, face or neck, they may also be entitled to a specific loss award.
Workers’ Compensation litigation is complex, and the employer or the employer’s insurance carrier will be represented by an experienced attorney. Workers’ compensation claims like personal injury cases are also prosecuted on a contingent fee basis. A workers’ compensation judge must approve any fee agreement before counsel fees can be paid. In the event an employee is successful in recovering benefits, all litigation costs are assessed against the employer.