Can I Get Money From Workmans Comp for a Scar?

Workman’s/Workers’ Compensation is supposed to pay you for injuries that keep you out of work, supplying both replacement wages and payment for medical expenses during this period.  However, Workers’ Comp also covers “specific loss” benefits, which might be able to pay you for scars in some situations.

Generally, any work-related injury should be paid for, so the initial treatment for a cut or burn should typically be covered, as well as lost wages while the injury keeps you out of work.  However, you may also be able to get “specific loss” benefits.  These are usually paid for any permanent loss or loss of function in a body part, but coverage for lost sight/hearing and significant scarring/“disfigurement” of the face, neck, or head can often be covered, too.

For help with your Workers’ Comp claim, contact Cardamone Law’s Certified Philadelphia Workers’ Compensation Lawyers today at (267) 651-7945.

Getting Treatment for Injuries That Will Scar Under Workers’ Compensation

When you suffer serious injuries, they are likely to leave scars.  As long as the injury is related to your work, any medical treatment you need for the injury should be covered under Workers’ Compensation.

What this means is that if you suffered a serious cut or burn at work and you needed to go to the hospital, they should cover all medical care you need to treat that injury.  If this includes simple stitches and bandages or treatment by a plastic surgeon to help prevent or reduce scarring, that should likely be included in your coverage as well.

If this cut or burn will keep you from working for an extended period, then you should also be able to get wage-loss benefits to cover your lost wages.  These benefits are typically paid at a rate of 2/3 of your normal wages or 2/3 of the difference between your pre- and post-injury wages, with some exceptions.

Some scars might also result from surgeries you needed to treat the injuries, such as the incision scar to get screws or rods implanted in a broken leg.  That care should be covered, but the scar itself would not receive benefits unless it meets the requirements below.

Specific Loss Benefits for Scarring Under Pennsylvania Workers’ Compensation

Scars might also be able to get you benefits directly for the scar itself, not just the underlying injury that caused the scar.  Alongside benefits for your medical care and your lost earnings, Workers’ Comp should also pay damages for what are called “specific losses,” which may include some scars – though there are requirements for a scar to be covered.

Specific Losses

Section 306 of the Workers’ Comp Act includes coverage for “specific loss.”  These injuries are permanent injuries that often involve amputation or loss of a body part, lost function in a body part, lost hearing or sight, or significant “disfigurement.”  Under this “disfigurement” category found in subsection (c)(22), there are additional requirements for the scar to be covered.

Requirements for Scar Coverage

The source of the scars is not at issue under these rules; you can get coverage for heat burns, chemical burns, cuts, scrapes, lacerations, surgical scars – any source of scarring.  Instead, the rules for coverage are based on how severe the scars are and where they are.

First, the scars must be “serious,” which would usually mean more than a small line or two.

Second, the scars must constitute “permanent disfigurement.”  Scars often fade with time, but the question of whether they are sufficiently “permanent” usually does not come up.  Additionally, most scars will qualify as “disfigurement”; this requirement is there to expand coverage beyond just scarring rather than limit it to only certain types of scars.

Third, the scars need to be on the neck, face, or head.

Fourth, they must “produce an unsightly appearance.”  Essentially, along with the “serious” requirement, scarring has to be somewhat substantial and obvious to be covered.  This is not supposed to be a question of opinion but rather an objective standard.

Lastly, the scarring has to be outside of what is typical in that job.  For example, welders may get small scars on their necks from sparks, but those are typical for that line of work and would likely not be covered.  Contrast this with a welder who suffers serious burns in a gas explosion and has half of their neck covered in scars; that certainly is not typical for welders and should likely meet the other requirements for coverage as well.

At the end of the day, this means that scars will have to be somewhat obvious and visible to get coverage.  However, you should always consult with our Pittsburgh Workers’ Compensation lawyers about whether your scarring qualifies for benefits or not, as many insurance carriers will try to reject your claim even if your scars should qualify.

How Much Are Benefits?

Each specific loss injury or condition listed in the Act has a specific number of weeks’ worth of benefits listed for it.  These are specified in the Act to be paid at a rate of 66 2/3% of your wages, but the number of weeks’ worth of wages changes depending on the injury.

For permanent, unsightly scars of the head, face, or neck, not incident to employment, a Workers’ Compensation Judge can award up to 275 weeks of wage loss benefits.

Coverage for Non-Facial Scars

As mentioned, the medical care to treat a scar should be covered, but scars are only covered for the sake of the scarring itself if they are on the face, neck, or head.  However, scars on other parts of your body may lead to benefits if the scars or burns result in loss or lost function for that part of your body.

For example, if you suffer serious burns that cause you to lose a finger or a hand, you get benefits for the loss, but you do not get additional payments for the scarring.  The same is true if you lose function from significant burns; this is covered equal to a loss/amputation.  Severe third-degree burns often result in these kinds of injuries, potentially causing lost function across multiple areas of the body.

Other Requirements

For you to get benefits for your injury, you also have to meet the other requirements for Workers’ Comp claims generally.  For example, your injury needs to be work-related – i.e., it needs to have happened in the course of your work.  You also need to report the injury on time to get your claim filed.

Call Our Pennsylvania Workers’ Compensation Lawyers Right Away

Call (267) 651-7945 for a free case review with Cardamone Law’s Bucks County, PA Workers’ Compensation attorneys.