Despite efforts by the state and federal governments to keep workplaces safe for workers, workplace injuries are relatively common in the United States. In 2010 alone, the Pennsylvania Bureau of Workers’ Compensation reports that 85,560 workers lost work time due to injuries and occupational illness. When an injury or illness is severe enough to cause lost time from the job, the subsequent loss of income could be financially devastating to a worker. Fortunately, workplace injuries and illnesses are covered by the Pennsylvania workers’ compensation system which provides a wage loss benefit to a worker who has lost wages.
When Is a Worker Entitled to Workers’ Compensation Benefits?
The workers’ compensation system is a no-fault system, meaning you are not required to prove that your employer was negligent in order to be entitled to benefits. Instead, eligibility for workers’ compensation benefits is based solely on the fact that you were working for your employer at the time of the injury and the injury or illness was work-related. Workers’ compensation also covers pre-existing injuries or illnesses that are exacerbated by your job.
What Type of Wage Loss Benefits Are Available?
If your claim for workers’ compensation benefits is approved, you may be entitled total or partial disability benefits. You are entitled to total disability wage loss benefits if a physician determines that you are unable to work at all. You may be entitled to partial disability wage loss benefits if a physician releases you to return to a “light duty” position that pays less than your previous position.
How Are Total Disability Wage Loss Benefits Calculated?
The amount of your wage loss benefits will depend, to an extent, on your income prior to the injury or illness. There is also a minimum and a maximum amount that is determined each year based on thestatewide Average Weekly Wage (AWW). For injuries occurring on and after January 1, 2018, the maximum compensation is $1,025.00 per week. If your pre-injury Average Weekly Wage falls between $768.76 and $1,537.50, yourtotal disability wage loss benefit will be 66 2/3 percent of your AWW, up to the maximum of $1,1025. For instance, if your AWW prior to your injury was $900, your wage loss benefit would be $600 ($900 x 0.6667). If your pre-injury AWW falls between $768.75 and $569.44, your wage loss benefit would be $512.50. Finally, if your pre-injury AWW is $569.43 or less, your weekly wage loss benefit is 90 percent of your AWW. For example, if your AWW prior to the injury was $400, your wage loss benefit would be $360 per week ($400 x 0.90).
How Are Partial Disability Wage Loss Benefits Calculated?
At some point, your physician may authorize you to return to a “light duty” assignment; however, that position may not pay as much as you were making prior to the injury or illness. In that case, you may be entitled topartial disability wage loss benefits. Partial disability wage loss payments are equal to two- thirds of the difference of the two salaries for a maximum of 500 weeks (9.5 years). For example, if your AWW prior to your injury was $900 and you now make $600 per week at your “light duty” position, you would receive $200 per week in partial disability wage loss benefits ($900-$600=$300, $300 x 0.6667= $200). In total, you would bring home $800 per week.
Calculating Your Average Weekly Wage
Given that your wage loss benefit amount is determined using your Average Weekly Wage, correctly calculating your AWW is extremely important. When calculating your AWW you are not limited to income from the employer against whom you filed your workers’ compensation claim. Instead, you should include the total ofall gross wages fromevery employer you had at the time you were injured or became ill. In addition, when calculating your AWW you should include overtime, bonuses, tips that were reported to the IRS, vacation pay, and per diem payments for food and/or lodging.