Pennsylvania workers' compensation is governed by the Workers' Compensation Act (77 P.S.). It is administered by the Department of Labor and Industry, and coverage is rated through the Pennsylvania Compensation Rating Bureau (PCRB). Pennsylvania is not a monopolistic state. Employers insure with private carriers or the State Workers' Insurance Fund (SWIF), or get approval to self-insure. This guide covers the Pennsylvania numbers. The standard policy, rating basics and federal programs are in the national Workers Compensation guide.

Securing coverage

• Employers must secure compensation by insuring or by getting approval to self-insure (77 P.S. 501).
• Failing to carry required coverage on purpose can bring criminal penalties, and the employer stays liable for benefits (501(b)).
• SWIF is a state-run workers' compensation insurer of last resort (77 P.S. 2601 et seq.).
• Subcontractors: if an uninsured subcontractor's employee is hurt, the general contractor is liable for benefits (77 P.S. 461).
• Uninsured employers: the Uninsured Employers Guaranty Fund pays when an employer has no coverage (77 P.S. 2701 et seq.).
• Insolvent carriers: claims are paid by the Workers' Compensation Security Fund. The P&C guaranty association excludes workers' comp (40 P.S. 991.1802).
• Rating: every WC insurer must belong to the rating organization, the PCRB, whose classifications and rating values insurers use (77 P.S. 1035.7).
• Safety committees: an employer with a committee certified by Labor and Industry earns a 5% premium discount each year (77 P.S. 1038.2).

Who is covered

• Sole proprietors and partners aren't covered automatically. They may buy coverage voluntarily, including from SWIF (WC Act sec. 451).
• Executive officers of a for-profit corporation who own at least 5% may elect not to be employees under the Act (77 P.S. 22).
• Occupational diseases listed or defined in the Act are covered when they arise out of and in the course of employment (77 P.S. 27.1).

Exclusive remedy and subrogation

• Benefits are the employee's exclusive remedy against the employer (77 P.S. 481). There are no pain and suffering damages.
• When a third party causes the injury, the insurer that paid benefits may pursue subrogation (77 P.S. 671).

Notice, claims and payment

Notice of injury (77 P.S. 631)

• If notice is given after 21 days, compensation runs only from the date of notice. Example: notice given on day 40 means benefits start from day 40.
• A worker who gives no notice within 120 days gets no compensation.

Claims and payment

• A claim petition is barred unless filed or agreed to within 3 years of the injury (77 P.S. 602).
• The first installment must be paid, or the claim denied, by the 21st day after the employer has notice (77 P.S. 717.1).

Fatal injuries

• Must be reported to Labor and Industry within 48 hours (77 P.S. 994).

Medical providers (77 P.S. 531)

• If the employer posts a list of at least six designated providers, the employee treats with a listed provider for 90 days from the first visit.

Benefits

Disability classes follow the usual pattern: temporary total, temporary partial, permanent partial (specific loss) and permanent total.

Common exam traps

• Not monopolistic. SWIF is the state-run insurer of last resort, and private carriers also write coverage.
• Notice: after 21 days, benefits run only from the notice date. After 120 days, there are no benefits at all. Claim petitions: 3 years.
• Waiting period: 7 days, paid back if disability lasts 14 days.
• IRE: after 104 weeks. Below 35% impairment means partial disability, capped at 500 weeks.
• Insolvent WC carrier: the Workers' Compensation Security Fund pays, not the P&C guaranty association.
• Uninsured employer: the Uninsured Employers Guaranty Fund pays.