When you are injured in an accident at work, your disability “status” is often an important part of how your claim is classified and what benefits you receive. Some states use a strict categorization that automatically changes benefit amounts when you change status, but Pennsylvania is a bit different.
Under Workers’ Compensation, benefits are usually categorized as “total” or “partial.” The main distinction is that “partial” disability status is for people with a “whole body impairment” under 35%. Total disability, rather, means you are completely disabled and unable to work. Total disability is paid as long as it lasts, whether it is “temporary” or “permanent,” but partial disability can only last 500 weeks.
Call (267) 651-7945 for a free case evaluation with Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers.
What Program Pays for Disabilities from Work Injuries?
Workers’ Compensation is a system designed to pay benefits to injured workers. This is required for all employers in Pennsylvania who have even one employee who could be hurt on the job.
This system pays for medical expenses to treat the work-related injury, replacement lost wages (not usually at their full value), and additional benefits for permanent amputations and total lost function, as well as lost hearing, lost vision, and facial scars.
These payments are provided by insurance that your employer is required to carry.
This is not to be confused with “disability” programs administered under Social Security or other “disability” insurance provided by your employer. Our Certified Pennsylvania Workers’ Compensation Specialists work to help injured workers get benefits under Workers’ Comp only, not other disability benefits programs.
How is Total vs. Partial Disability Status Defined in Workers’ Comp?
Pennsylvania’s Workers’ Compensation system has two “statuses” for disability. These primarily affect your wage-loss benefits, as medical care should be covered regardless of your disability status.
Total Disability
When you are initially injured and unable to work at all because of your work-related injury, you are considered totally disabled. This total disability status lasts as long as you are unable to work and your whole body impairment rating has not fallen below 35%.
There is no legal distinction in pay rates or status between “temporary” and “permanent” total disability.
Partial Disability
Partial disability status is applied when your whole body impairment rating falls below 35%.
After you are on total disability for 2 years, your employer is allowed to send you to an Impairment Rating Evaluation (IRE) and may do so every 6 months after that. If that evaluation determines you are under 35% whole body impairment, then you will be switched to partial disability status.
How is Partial Disability Status Determined?
If you are on Workers’ Comp for two years, then your employer can request IREs at that point and every 6 months after that. At this evaluation, your employer hires a doctor to examine you and evaluate your disability under the American Medical Association’s 6th Edition of the “Guides to the Evaluation of Permanent Impairment.”
As long as your impairment rating is 35% or higher, you keep your “total disability” status. If you come in under 35%, then your status is changed to “partial disability.”
Do My Benefits Change if I Go to Partial Disability Status?
When you start getting your benefits as total disability benefits, the rate will not change just because you switched to partial disability status so long as your actual earning capacity has not changed. If you do return to work, then your earning capacity has changed, and your benefit rate can change.
Initial Benefit Rate
When you get benefits for lost wages, they usually come at 2/3 of your Average Weekly Wage (AWW) before the accident. This is typically calculated by looking at your fixed weekly wage or by converting your monthly or yearly pay rate to a weekly rate. If you do not have much work history at this job or you work seasonally, there are other rules about how to calculate the AWW.
Your benefits are also capped at the statewide AWW. This rate is set by law each year (e.g., the 2025 statewide AWW is $1,347).
If 2/3 of your wage would be over that amount, you are capped at the statewide AWW. You also cannot get less than 1/2 the statewide AWW or 90% of your AWW, whichever is lower.
Does This Change?
If you have not returned to work, but your disability status changes to partial disability, your wage-loss benefit rate does not automatically change. Some states do change your pay percentage based on classification, but Pennsylvania does not.
Instead, there has to be an actual change in earning capacity before the pay rate can change. This usually happens when you actually return to work with limitations or accommodations, as you may receive a reduced wage when that happens.
Benefit Rate While Working
If you do return to work and make less now than you did before the accident, your benefit rate changes. Instead of 2/3 of your total AWW, it would be 2/3 of the difference between your AWW before and after the accident.
This essentially makes up for the difference, but it cannot result in more than you would make under total disability.
How Long Do Total and Partial Disability Last?
Total disability last for as long as you remain totally disabled. Your status remains the same whether your condition is temporary or permanent until an actual change happens.
Ongoing IREs may reveal whole body impairment status below 35%, which can change you to partial disability status. Many injuries are obviously disabling, and these IREs continue to be a hassle if your disability is permanent, though settling your claim can stop the need for them.
If you are switched to partial disability status, you can only get 500 weeks total. This might not be consecutive, as you could actually change back to total disability status if your condition worsens again. You could also potentially go off disability and return to full-time work with no lost earnings, in which case your benefits would stop. Then, if your disability flares back up or gets worse, you could return to partial disability status.
All in all, you can only get 500 weeks of partial disability benefits in total, but total disability can last your whole life. However, the pay rate does not change; it is always based on wages in the year of injury and does not change for inflation. As such, staying on total disability forever is often a financial hardship.
Call Our Workers’ Compensation Lawyers in Pennsylvania Today
For help with your case, call Cardamone Law’s Scranton, PA Workers’ Comp lawyers at (267) 651-7945.
