Pennsylvania workers' compensation insurance: Your ultimate resource

Who is covered?

Policies include protection for full and part-time employees.

Some exemptions from workers’ comp in Pennsylvania include:

• Railroad workers
• Longshoremen
• Federal employees
• Domestic servants
• Agricultural workers who work fewer than 30 days or earn less than $1,200 in a calendar year

Covered injuries and illnesses

Workers' compensation covers a range of work-related injuries and illnesses, including physical injuries resulting from an accident and occupational diseases developed over time due to job conditions. 

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Benefits provided

Pennsylvania workers’ comp insurance provides four types of benefits for work injuries:

• Medical benefits
• Lost wages 
• Specific loss benefits 
• Death benefits

These benefits include:

• Medical treatment for work-related accidents, injuries and/or illnesses 
• Total disability benefits 
• Partial disability benefits
• Awards for permanent loss or disfigurement 
• Benefits to surviving dependants

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Pennsylvania workers’ compensation rates

The weekly wage loss benefit is two-thirds of the employee’s average weekly wage, not to exceed or fall below a maximum and minimum amount set by the Department of Labor and Industry.

Find more information on Pennsylvania’s benefit rates.

Filing a workers' compensation claim

In the event of a work-related injury or illness: 

Step 1: Employee reports injury to employer 

Employees in Pennsylvania should report their injury to their employer immediately but no later than 21 days from the accident.

Step 2: Seek medical care

The employee should immediately seek medical attention. 

Step 3: Employer reports injury

Once notified of the injury, employers should file a report within 48 hours for injuries resulting in death and seven days for injuries resulting in one missed day or shift from work. 

Step 4: Receive benefits

If an employer’s insurance provider accepts the claim, the worker should begin receiving benefits to cover medical expenses and lost wages. 

Step 5: Return to work safely or receive total disability benefits

Following their recovery, a worker is expected to resume work safely. If a work injury has left an injured employee unable to do any type of work, the employee might be entitled to permanent disability benefits..

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Choosing a healthcare provider 

In Pennsylvania, injured workers can choose their healthcare provider unless their employer has provided a list of six or more physicians or healthcare providers. If the employer has provided a list, the injured worker must visit a provider on the list for initial treatment for 90 days following the first visit. 

After 90 days, the injured worker may seek treatment with any physician or healthcare provider, and they must notify their employer of who they select. 

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Compensation for missed work

If an employee is out of work:

• Less than seven days: They are not eligible for disability payments. 
• More than seven but less than 14 days: They are eligible for lost time benefits beginning on the eighth day. 
• More than 14 days: They are eligible for benefits retroactive to the first day they stopped work.   

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Resolving disputes

If an employee or employer wishes to dispute a claim, they can use the Bureau of Workers’ Compensation’s alternative dispute resolution services. In alternative dispute resolution, the two parties talk informally with the help of a workers’ compensation judge to come to an agreed settlement. Alternative dispute resolution includes mediation, settlement conferences or informal conferences.