pennsylvania Workers' Compensation: Fast Facts

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Coverage Requirements Under Pennsylvania State Law

Most Pennsylvania businesses with at least one employee must carry workers' compensation insurance. This includes all part-time, full-time, and seasonal workers starting on day one of employment. See a list of workers automatically exempt from this coverage requirement below.

Work-Related Injury or Illness Reporting Requirements

Tell your employer immediately when you have a work-related injury or illness, but within 21 days (3 weeks). Ask if you need to see a doctor authorized by your employer's insurer before you seek non-emergency medical care. (For life-threatening injuries, head to the closest hospital, ER, or clinic before you report it.) Once you're stable, make sure to notify your employer about the incident as soon as possible. State law says that your employer owes you no benefits until after you report your workplace incident. You must report it within 120 days or else lose your right to claim any Pennsylvania workers' compensation benefits.

Where to Seek Medical Care

Look for a list of authorized healthcare providers in your workplace somewhere that's visible to everyone, like a break room. You can also ask your supervisor for a list of doctors you can see to treat your injury or illness. State law says you can only see one of 6 authorized doctors for the first 90 days you need care. But if no such list exists, you can see any doctor you choose — including your own family physician. Going to your own doctor without prior approval from your employer means you'll have to pay those medical bills yourself.

Waiting Period for Lost-Wage Benefits in Pennsylvania

Your first 7 days off are always unpaid unless you cannot go back to work for at least 2 weeks. Once you need at least 15 days off to recover, workers' comp covers those first 7 days you missed work. If you don't need at least a week off to recover, then Pennsylvania workman's comp only pays your medical bills.

Pennsylvania Workers' Compensation Statute of Limitations

You have three years from your work injury or illness diagnosis date to file for Pennsylvania workers' compensation.

Pennsylvania Weekly Compensation Rate

You can receive 66 2/3% of your gross average weekly wage (AWW), subject to the state's maximum and minimum amounts.

How Long You Can Receive Pennsylvania Workers' Comp Benefits

  • Medical benefits: unlimited
  • Death benefits: $7,000 for funeral and burial expenses, plus up to 66 2/3% of the deceased worker's AWW until the surviving spouse remarries or dies; remarriage triggers a lump-sum payment equal to 104 weeks of TTD payments
  • Temporary Total Disability (TTD): until you return to work, or up to 104 weeks; at that time, you must undergo a medical exam to determine if you qualify for PPD benefits
  • Permanent Partial Disability (PPD): multiply 2/3 of your pre-injury AWW by number of weeks established under the law for the loss in question, but no more than 275 weeks of TTD benefits for disfiguring injuries
  • Temporary Partial Disability (TPD): 2/3 of the difference between your pre-injury and post-injury wages paid for up to 500 weeks, max
  • Permanent Total Disability (PTD): TTD benefits for the duration of disability, but no more than 500 weeks

Pennsylvania Workers' Comp Coverage Exemptions

The following employees are automatically exempt from Pennsylvania workers' compensation coverage requirements:

  • Agricultural workers earning less than $1200 per calendar year
  • Casual workers
  • Domestic workers who elect not to have coverage
  • Executive officers in non-profit organizations that serve on a volunteer basis
  • Business partners
  • Employees granted exemptions from coverage based on their religious beliefs
  • Federal employees, including longshoremen and railroad workers
  • Independent contractors
  • Licenses real estate sales reps or associate real estate brokers working on commission
  • LLC members, partners, and owners
  • Sole proprietors

Pennsylvania Workers' Compensation Attorney Fees

All Pennsylvania workman's comp attorneys work on contingency. This means you only pay legal fees when your case wins. If you don't win, then you owe your lawyer $0. Pennsylvania workers' comp lawyers cannot charge more than 20% of your past-due benefits in legal fees.