FAQs for Employers on Pennsylvania Workers’ Compensation Benefits

October 25, 2017

By Thomas E. Panzer

Based upon the Pennsylvania Statewide Average Weekly Wage, the maximum compensation payable under the Workers' Compensation Act, is $995 per week for injuries occurring on and after Jan. 1, 2017. As an employer, you have the responsibility to provide workers’ compensation coverage to your employees. You also have the right to protect your business against claims that are fraudulent, unwarranted or unrelated to work activities, or for injuries caused by your employee’s drug or alcohol use.

Following are some frequently asked questions to help guide you through the workers’ compensation process:

Q: I don’t have any employees. Do I need to carry Pennsylvania Workers’ Compensation Insurance?

A: The definition of “employee” is broader than people think. Certain laws expand the definition of employee to include workers which a company or a self-employed individual may consider an independent contractor. In fact, you may not have even met an individual, much less hired them, but the law may consider them an employee for purposes of workers’ compensation. For example, in the construction field, a general contractor may enter into a contract with a subcontractor. If an employee of the subcontractor is injured in the course of that employment, he may be considered an employee of the general contractor.

Q: If my company is principally located in another state, and we only rarely send employees to or through Pennsylvania, do I need Pennsylvania Workers’ Compensation insurance?

A: If an individual is hurt while in the course and scope of his or her employment, while in Pennsylvania, the Pennsylvania Workers’ Compensation system most likely will have jurisdiction – even if that jurisdiction is concurrent with another state’s jurisdiction. Defending a workers’ compensation claim can be an expensive proposition. Insurance coverage should carry with it a “duty to defend,” and thereby could mitigate the expense of any direct legal fees to you, as the employer, if a workers’ compensation claim is filed.

Q: What if I don’t carry Pennsylvania Workers’ Compensation coverage?

A: There are criminal penalties for intentionally failing to carry Pennsylvania Workers’ Compensation coverage.  An uninsured defendant in a Pennsylvania Workers’ Compensation matter may also be sued at common law under negligence theories. The remedies at common law may exceed those under the workers’ compensation laws. In addition, the responsibility to defend the matter will rest on your business, as opposed to an insurance carrier. In other words, insurance is required by law. Failure to insure carries with it serious consequences, both civilly and criminally.

Q: What if my employee’s work injury is someone else’s fault?

A: If your employee is injured while in the course and scope of his or her employment, your workers’ compensation insurance should cover the risk.  In fact, because the injury is covered under the workers’ compensation system, the employer is generally insulated from being sued by the employee at common law. If the injury is caused by the negligence of some third party, the employee can sue the third party at common law, and if the employee recovers, your insurance carrier gets a portion of the workers’ compensation payments made back under the subrogation provisions of the Pennsylvania Workers’ Compensation Act. Subrogation is a means to mitigate “double dipping” by not allowing an individual to recover damages from two separate sources for the same injury or incident without coordination. This is one example of coordinating potential remedies and benefits under the Pennsylvania Workers’ Compensation system.

Q: Is my employee eligible for Unemployment Benefits while claiming entitlement to Workers’ Compensation Benefits?

A: There are circumstances where an employee may be eligible for both unemployment and workers’ compensation benefits at the same time. However, the workers’ compensation carrier is entitled to a dollar for dollar credit against unemployment benefits received. There are other coordinated concurrent benefits. An employer is entitled to a dollar for dollar offset for pension benefits received by an injured worker, to the extent funded by the employer directly liable for the work injury. An employer is entitled to a 50% offset for Social Security Retirement benefits. All public and employer provided benefits should be assessed in the context of a workers’ compensation claim.

High Swartz has considerable experience in defending employers in the defense of workers’ compensation claims. We are proud of our record and results. While past results are not a guarantee of future success, we would welcome a chance to put our workers’ compensation attorneys to work for your business. Please contact Thomas E. Panzer at 215-345-8888 or tpanzer@highswartz.com. Our attorneys in Bucks County and Montgomery County are here to assist you.

The information above is general: we recommend that you consult an attorney regarding your specific circumstances.  The content of this information is not meant to be considered as legal advice or a substitute for legal representation.

 

 

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