Injuries in the course of your work deserve compensation from your employer. Workers’ Comp is designed to pay workers after injuries they acquire while they are just doing their jobs, but getting compensation can be difficult.
Our attorneys fight to help injured workers get the compensation they need from Workers’ Comp. This legal system is different from traditional injury cases, and it can be difficult to understand how to report your injuries, what your case is worth, and how things like return to work are supposed to happen.
For a free review of your case, call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Specialists at (267) 651-7945 today.
What is Workers’ Comp?
Workers’ Comp is a special system designed to get injuries and lost wages paid for workers without making them file a lawsuit. When you file a traditional lawsuit, you need to prove that the defendant was at fault, but many injury cases are accidents or cannot be blamed directly on the employer. This requires a different system.
Workers’ Comp works a bit like this:
- You report your accident to your employer.
- They are required to cover a portion of lost wages and all medical care, regardless of who caused the accident.
- Their Workers’ Comp insurance carrier will typically deny claims, giving you a chance to file in court.
- Our attorneys file a Claim Petition before a specialized Workers’ Comp Judge (WCJ) to come to a settlement or achieve benefits for you through a hearing.
- Ongoing benefits can be paid to cover you while you are out of work, or if your injuries become permanent.
What Damages Does Workers’ Comp Pay in Pittsburgh?
Workers’ Comp benefits pay in three major areas:
Medical Benefits
Medical benefits cover all medical care you need to treat your work-related injuries. There is no pre-approval requirement: if your doctors say you need the care, and your claim has been granted, the care is supposed to be covered so long as it is provided by a properly licensed provider.
This covers serious, expensive care like surgeries, but it also covers rehabilitation and other ongoing services.
Wage-Loss Benefits
If you are unable to work because of your injury, Worker’s Comp helps make up for your lost earnings:
- If you are totally unable to work, you receive 2/3 of your pre-injury average weekly wage (AWW), following certain caps and floors.
- If you can work a bit with reduced wages, you receive 2/3 of the difference in pre- and post-injury AWWs.
These benefits last for as long as you are unable to work. After your injury begins to heal up, you may be switched to “partial disability status” if you undergo an impairment rating evaluation (IRE) that puts your whole-body impairment rating under 35%. If that happens, these benefits only last another 500 weeks.
Specific Loss Benefits
These permanent injuries receive additional benefits, paid for a number of weeks based on the specific injury you face:
- Significant facial scarring
- Lost vision
- Lost hearing
- Amputation/lost function.
The pay rate for these benefits is 2/3 of your pre-injury AWW, subject to caps and floors.
Can You File a Lawsuit?
Workers’ Comp potentially allows coverage in situations where a lawsuit would never succeed:
- You can’t sue if you were at fault
- Lawsuits are not allowed against employers for work-related injuries
- Some “freak accidents” have no one to actually blame.
Third-Party Claims
However, Workers’ Comp still covers you in situations where a lawsuit might be available, such as when an outside company or individual is responsible for the accident. In these “third-party” claims, you can still sue that outside party, even if you get Workers’ Comp first.
This often allows claims against
- Drivers
- Customers
- Outside contractors, vendors, suppliers, etc.
- Equipment manufacturers.
Double Recovery Issue
If you recover the same damages through both your lawsuit and the Workers’ Comp claim, the insurance company can typically claim back the damages they paid you.
This is a bit complex, but it usually means you can get paid quickly through Workers’ Comp (e.g., in around 3-8 months). That can then cover your needs while you take longer (potentially upwards of 1-2 years) to litigate your personal injury claim.
Other Damages
Workers’ Comp does not pay for things like pain and suffering or incidental expenses at home (e.g., childcare while you are hospitalized). These additional damages can be worth quite a bit, and they can only be recovered in a lawsuit.
What Lawyer to Use
Our Workers’ Compensation attorneys can handle both your Workers’ Comp claim and your personal injury lawsuit.
FAQs for Workers’ Comp Claims in Pittsburgh
Who Pays Workers’ Comp?
Technically, the employer is required to pay your Workers’ Comp benefits. However, employers are also typically required to have Workers’ Comp insurance, meaning that the insurance carrier is ultimately making the decisions and actually paying the money.
What Are the Caps and Floors on Wage-Loss Benefits?
The Workers’ Comp Act limits your weekly wage loss benefits to a maximum of the statewide AWW. This is set by law each year and therefore might not literally reflect the statewide average wage. For 2025, this was $1,347 per week, and it usually goes up from year to year.
These wages also have a floor set at whichever is lower: 90% of your AWW or 50% of the statewide AWW. The floor for specific loss benefits is just 50% of the statewide AWW.
When Do I Get My Benefits?
When you report your injury, your employer gets 21 days to decide whether to pay. If they grant your benefits, you can receive payments right away. If not, and we have to fight the case before a WCJ, it can often take 3-8 months, or longer in complex claims. Settlements typically pay within 30 days.
Medical benefits go directly to the healthcare provider. Your wage-loss benefits are paid weekly or bi-weekly (according to your pre-injury work schedule).
How Does Settlement Work?
Workers’ Comp claims can be settled, but this can happen in a few ways.
- Your employer can offer to pay the full value of your claim in one sum instead of providing ongoing benefits.
- After you have been on benefits and your condition is stable (or your disability is permanent), we can predict the total value more easily, and they can settle your case then.
- Claims can also be settled on the wage-loss side only, providing easily calculated wages in a lump sum while you continue to get medical care covered as it comes up.
Never settle without speaking to a lawyer first. You cannot go back and claim more money after settlement.
Call Our Pittsburgh Work Injury and Workers’ Comp Lawyers Today
For a free case evaluation, call our Workers’ Comp lawyers at Cardamone Law today at (267) 651-7945.
