In Pennsylvania, injured workers who cannot return to work are entitled to be paid wage losses, often called “indemnity benefits.” There are two types of indemnity benefits: (1) total temporary disability benefits, and (2) partial disability benefits. Total temporary disability benefits are paid when a worker is unable to work at his or her pre-injury job and is not working at any other employment. Partial disability benefits are paid when a worker has returned to work at modified duty (such as a light duty job) and still has an earnings loss.
Workers' compensation wage loss benefits are calculated based upon an injured worker's average weekly wage. In general, most employees receive workers' compensation benefits equal to roughly 2/3rds of the wages they earned before their work injury. Unfortunately, calculating wage loss benefits is not always easy.
Workers' compensation wage losses benefits are calculated under Section 306 of the Pennsylvania Workers' Compensation Act, which is lengthy and, at times, confusing. For example, extremely high paid workers will not receive 2/3rds of their pre-injury wages because the law caps the amount they receive. On the other hand, workers who earned less than the average worker (statewide) receive either a fixed rate or 90 percent of their prior average earnings, depending upon a number of factors.
In 2008, for example, the maximum weekly benefit that an injured worker could receive was: $807.00; it will increase in 2009. This means that any worker who earned an average of $1,210.50 or more a week can receive no more than $807.00 in weekly wage loss benefits. Although workers' compensation benefits are not taxable, the reality is that many high-paid workers find themselves in serious financial difficulty because of this cap.
Workers who earned between $1,210.50 and $605.26 per week in 2008 received 2/3rds of their average earnings, while workers earning between $605.25 and $448.33 received $403.50 (a set rate). Finally, lower paid workers (those who earned $448.32 or less per week), receive 90 percent of their average wages in Pennsylvania workers' compensation benefits.
There are a few other “details” you should know. Workers who are out of work for seven days or less do not receive any workers' compensation wage loss benefits. Workers who are out of work from eight to 14 days are subject to a seven day waiting period. This means that workers who, for example, miss ten days of work, will only be paid for three). For all other workers, who are out of work for more than 14 days, get paid from day one; there are no deductions or waiting periods.
Separately, workers who suffer amputations, loss of vision or hearing, or lose the use of one part of their bodies, may receive “specific loss benefits” under the Pennsylvania Workers' Compensation Act. People who suffer specific losses receive a specific amount of benefits for their injuries. For example, workers are paid for 335 weeks for the loss of a hand, 370 weeks of the loss of the forearm, and 250 weeks for the loss of a foot. The statute specifies the compensation for each body part.
Finally, most insurance companies pay benefits every other week, although a few pay wage loss benefits weekly. These benefits are not taxable. As you can see, calculating benefits under the Pennsylvania Workers' Compensation Act can be complicated.
Workers Compensation Act 1998
The wars in Iraq and Afghanistan have introduced a new range of injuries to standard workers' compensation - IED attacks, Al Queada rocket attacks, and other war related dangers have resulted in unthinkable internal and external damage, traumatic brain injuries, and Post Traumatic Stress Disorder (PTSD).
Most of the injuries we see coming out of Iraq and Afghanistan are actually of the same nature that we see here in employment in the states - knee injuries like torn knee ligaments or miniscus, shoulder injuries, usually torn rotator cuffs, and back injuries like herniated (slipped), or extruded (ruptured) discs. The human body is fragile and unfortunately there are a select few parts of our bodies that tend to give out under the right/wrong conditions.
Sadly, the dangers of war have introduced new kinds of physical trauma to a system typically reserved for more common problems. It is important to note that any injured contractor is entitled to:
"such medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus, for such period as the nature of the injury or the process of recovery may require." 33 U.S.C. Section 907(a)
For those with extreme measures of injuries, this can result in extreme measures of treatment, surgery, and rehabilitation.
One such example is Ronnie Grigsby of Handen, Idaho. He was thrown from a vehicle in Iraq and suffered a broken neck and "Traumatic Brain Injury." Lucky to be alive, Mr. Grigsby has had a long road back to any form of normalcy. Ronnie has had to re-learn how to walk and talk. He has lost the ability to taste or smell, and sees double without the aid of corrective glasses.
Cases such as Mr. Grigsby's often require in-home medical attendants, modifications to the injured claimant's home, prosthetic devices, implanted stimulator units, implanted morphine pumps, or even massage or hot tub therapies.
There is no limit to the costs that the insurer is required to pay. It is not like a health insurance policy with a lifetime limit, or specific coverage limits for certain types of care. The insurer has the duty:
"to furnish appropriate medical care for the employee's injury, and for such period as the nature of the injury or the process of recovery may require." 20 C.F.R. 702.402
If your condition warrants it and your doctor requests approval of a device, procedure, or treatment, you deserve that treatment from the workers' compensation insurer. It is important to note that courts have held that if an employee's injuries are so severe as to require domestic services, the employer must provide them, even to the extent of reimbursing a family member who performs them.
Both Jack B. Katz & Aaron Walter are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Jack B. Katz has sinced written about articles on various topics from Legal Matters, Compensation Claims. Philadelphia workers compensation attorney Jack B. Katz, who has been representing injured workers for more than two decades. Jack Katz concentrates his practice in workers compensation matters. His office is located at 1213 Vine Street Philadelphia, PA 1. Jack B. Katz's top article generates over 1300 views. to your Favourites.
Aaron Walter has sinced written about articles on various topics from Legal Matters, Life Insurance Annuity and Legal Matters. Aaron Walter is an attorney in Marietta, Georgia. He specializes in and cases involving injured Iraq contractors under th. Aaron Walter's top article generates over 8100 views. to your Favourites.
Born On November 14 On Tuesday, November 14, Majel Barrett Roddenberry joins son Eugene Rod Roddenberry and writerdirector Nicholas Meyer for a special 40th Anniversary Star Trek Celebration at the world famous Gr...