Workers' Compensation Law
Workers’ Compensation Law is a statute passed by the Legislature of the Commonwealth of Pennsylvania which precludes an employee from suing the employer and is the exclusive remedy the employee
has in an action against the employer.[77 PS 481] The intent of the Workers’ Compensation Law has been to allow the employee to receive his wages and have medical bills paid upon being
injured. The Workers’ Compensation Law in the Commonwealth of Pennsylvania is generally consistent with the laws in every jurisdiction in this country.
The latest change to the Workers’ Compensation Law was in June 1996. The major changes in the prior law was to allow for an offset if the employee receives a pension, severance pay or Social Security benefit while on Workers’ Compensation [Section 204(a)]. It also provided for a new concept of partial disability based on the AMA guideline for permanent impairment and limits the period of temporary total disability benefits to no more than 104 weeks (2 years) unless the impairment is equal to or greater than fifty percent of the body as a whole [Section 306(2)]. It also gave the employer the benefit from extending the medical treatment from the employer from thirty days to ninety days [Section 306(f.1)(1)(i)]. It changed the average weekly wage calculations [Section 309]. Finally it had a number of procedural changes, more meant to how the claim is processed and managed than it is to the substantive law under workers’ compensation.
Workers’ Compensation Act provides workers’ compensation benefits in the form of a percentage of the employee’s wages up to a maximum amount set by the Legislature on a year to year basis. It also provides medical benefits to the employee for injuries received on the job. The employee is required to use the benefits from the workers’ compensation carrier prior to using any insurance coverage from his own accident and health insurance provider.
A claimant, namely an injuried employee, must file a Claim Petition as soon as he has any knowledge of the injury. No payments will be made until a petition has been filed either by the claimant or by the employer and a determination that one, an injury has occurred, two, during the course of the employment, and three, the employee is unable to work. Workers’ compensation also applies if the employee during the course of employment suffered a fatal injury. The benefits at that point would go by statute either to the wife or the children or the parents depending on who was alive and what the structure was in the family itself. The structure again is controlled by the statute. If both parties agree there is a compensable injury and they agree on the amount of workers’ compensation wages that should be paid, no hearing is necessary.
The Hearing Procedure
If the parties, namely the employee and the employer, are unable to agree on the fact there was an injury and/or it is a compensable injury and/or what the compensation should be, a hearing will be held in front of a Workers’ Compensation Judge at a specific location. The Workers’ Compensation Judge will then hear the matter in a setting similar to a trial but with less constraint in regards to admission of evidence, rules of procedure and testimony. The Workers’ Compensation Judge will then enter a decision, either granting the claimant his injury or determining the claimant had not met his burden and therefore find for the employer.
An appeal to the Workers’ Compensation Appeal Board may be taken and a subsequent appeal to the Commonwealth Court if so desired.
If the parties are unable to agree on compensation, this is not an area that generally an employee should move forward in without legal representation. The employee obviously is also the client because he is requesting the claim be approved and payments be made. The statutory provisions are extensive, the rules for procedure are even more extensive, and a failure to comply with either the statute and/or the rule will lead to a determination that the claimant will not be successful and the employer will not be required to make compensation payments.