How Are Workers’ Compensation Payments Calculated in Pennsylvania?

Workers seeking Workers’ Compensation often want to know the basics of their case, such as whether they have a case and how much they will receive in benefits. While questions about the strength of your case often require us to look into the specific facts of your case, calculating the benefits you should receive can be a bit more straightforward since a lot of that information is found right in the Workers’ Compensation Act.

Under Pennsylvania law, workers are entitled to have their medical bills paid in full. In addition, they receive payments for their lost wages, typically totaling 2/3 of their lost earnings. This calculation is based on your average weekly wages, and there are certain caps placed on these payments as well as situations where your benefits actually go up to 90% of your normal wages.

If you were hurt at work, call our Certified Pennsylvania Workers’ Compensation Specialists at Cardamone Law for help today by reaching out to us at (267) 651-7945.

Calculating Medical Payments for Workers’ Comp in Pennsylvania

Generally, we cannot calculate how much the specific medical care in your case will cost without diving deep into the facts of your case. Every injury is different, and even the billing costs for certain procedures will vary based on the doctor or hospital network where you seek treatment. However, once we take your case and begin to understand what injuries you face and what expenses these result in, we can help you calculate these costs.

This is often an incredibly important part of your case if you are considering a lump-sum settlement. When you take a settlement, you cannot get further compensation for your medical bills. Because of this, it is very important that our Delaware County Workers’ Comp attorneys properly calculate your medical bills and ensure that there is enough money in your settlement to cover your care going forward.

Wage-Loss and Indemnity Benefits for Workers’ Comp in Pennsylvania

In addition to medical benefits, injured workers are usually entitled to weekly wage-loss checks to offset their lost wages. These benefits are also called “indemnity” benefits and are intended to cover you while you are disabled from a work injury.

At the end of the day, these benefits usually do not pay 100% of your lost wages, but this is still okay for two major reasons. For one, your medical bills are still covered in full, and they will often cost far more than the portion of your lost wages that goes unpaid. Second, you get these benefits without having to even prove that your employer was at fault for your injury; as long as the injury was work-related, you can get these benefits even in cases where a lawsuit would not be possible.

Calculating Average Weekly Wages in Pennsylvania Workers’ Compensation Cases

The wage-loss benefits that you receive are paid as a percentage of the average weekly wages you got before you were injured. Calculating this value is somewhat complex, but the Workers’ Compensation Act lays out the rules in § 309.

Calculating Based on Fixed Wages

If you get paid weekly at a “fixed” value, that makes calculating your weekly wage really easy: you just use that set weekly wage.

If you get paid monthly, the Act says to multiply that weekly wage by 12 to get your yearly wage, then divide it by 52 to get the weekly value. If you get paid yearly, the Act says to divide your salary by 52.

Hourly Wages

If your wage is paid hourly, then your weekly wage is going to vary based on your hours worked. This is especially true if you just recently got a raise or if you just started your job.

A year is 52 weeks, which can be evenly split into 4 periods of 13 weeks. The Act breaks down your work into 13-week chunks to help calculate your average wages if you get paid hourly.

If you have a full year of work at this job, then the Act just looks at your 3 highest 13-week periods to calculate the average. If you worked less than a year, then the Act says to use however many 13-week periods of wages you have available.

If you have yet to work a full 13 weeks at your job, the Act says to estimate however many hours you were hired to work and calculate the expected wages for that period.

Seasonal Work

There are many workers who make more money in certain seasons – such as agricultural workers, ski resort workers, or summer camp counselors. The law has special rules to calculate your average weekly wage as 1/50th of your total wages for the year. There are other exceptions if this isn’t a fair reflection of your wages.

Multiple Jobs

If you work multiple jobs but this injury keeps you from doing any of them, then your wages from all employers should be put into the calculation.

Calculating Lost Wage Benefits in a Pennsylvania Workers’ Comp Claim

Now that we’ve arrived at what your average weekly wage is, we can calculate your benefits based on this value. But first, we need to compare your wage to the statewide average.

Benefits are capped at the statewide average weekly wage, which is deemed to be $1,325 for 2024. Your benefits cannot go over this limit.

66 2/3% Rate

Otherwise, you usually receive 66 2/3% of your average weekly wage. $1,325 is 66 2/3% of an average weekly wage of $1,987.50, so any wages over that will not increase your benefits. For wages from $1,987.50 to $993.76, the 66 2/3% rate holds firm.

If you have “specific loss” benefits based on an amputation or lost function, then those benefits should be 66 2/3% of your average weekly wage set for a specific number of weeks based on the specific injury. Our lawyers can help you find the right section of the code for your specific injury.

Up to 90% Rate

If your wages are below $993.76 per week, you can actually receive more than 66 2/3%. If your average weekly wage is $993.75, then 66 2/3% would be $662.50 per week. This value is the rate paid for wages down to $736.11, at which point that value is actually a full 90% of your lost wages.

For wages below this $736.11 per week rate, you also get 90% of your average weekly wage.

Other Rates

Disabilities are usually categorized as “total” if your medical impairment is 35% or higher and “partial” if it is under 35%. Accordingly, people on partial disability usually receive a lower compensation rate. This is calculated by taking 66 2/3% of the difference between your average wage before your injury and now. This is usually set by a Workers’ Compensation Judge or by an agreement.

Your wage-loss rate can also be negotiated or paid as part of a lump-sum settlement, potentially at a different rate.

Call Our Certified Pennsylvania Workers’ Compensation Specialists Today

Contact Cardamone Law for help with your case by calling our Northeast Workers’ Compensation attorneys at (267) 651-7945 today.