PA Workers Comp: Average Weekly Wage adjustments for 2013

The Pennsylvania Department of Labor and Industry in early January published the new average weekly wage rates for 2013.  What is average weekly wage?  The average weekly wage determination is one of the most important aspects of your workers’ compensation case because it dictates what your actual compensation rate will be if you are out of work because of a work injury.

Indemnity benefits, otherwise known as wage loss benefits, are payable when you are out of work or when you are working light duty and making less than your pre-injury wages. The amount of indemnity benefits an injured worker receives is generally calculated by multiplying the preinjury average weekly wage of the worker by two-thirds.  If your earnings are below $509.43 per week, then your indemnity benefits generally can be calculated at 90% of your preinjury average weekly wage, with minimums and maximums established by law.  It is also important to note that if you are injured at one job and that injury also prevents you from working your second job then you may be entitled to add the wages of the second job to the wages of the first job to calculate your average weekly wage.  It is important to let us know if you work a second job.

Your average weekly wage is determined by calculating your wages over your four periods of 13 weeks.  You eliminate the lowest of the four periods, add together the other three periods, then divide by 3. There are other nuances in determining your average weekly wage if you worked less than four quarters or less than a quarter.

Here is the 2013 statewide average weekly wage:

1.  Wages between $687.76 per week and $1,375.50 per week are determined by multiplying wages by 66 2/3%.  Maximum average weekly wage is $917.00.

2.  Wages between $509.44 and $687.75 per week yield an average weekly wage of $458.50.

3.  Wages under $509.43 per week are determined at 90% of weekly pay.

If you think your average weekly wage may have been calculated incorrectly, we urge you to give us a call.  If you are uncertain, give us a call.  The average weekly wage determination is critical because your indemnity benefits are base don your calculated average weekly wage.  Call us today at 717-632-4656 or 1-877-632-4656.  Our offices serve injured workers in the following counties:  Adams, Cumberland, Dauphin, Franklin, Fulton, Perry,and York.

Treating with your Employer’s panel doctor

One question I frequently get from potential workers’ compensation clients is how long must I treat with a panel doctor/provider.  The answer is, it depends.  There are a few nuances about the treating with a panel doctor that could effect your case.

First, the general rule is simple.  If your employer has a panel list of provider, the PA Workers Compensation statute requires you to treat with the panel provider for the first 90 days after your injury date.  Does that mean you can’t see any doctor of your choice during that time period?  No.  It just means if you chose to go your own doctor or get a second opinion within the 90 days, the workers compensation insurance carrier can properly deny paying for that medical bill.  However, you are permitted to treat with your own doctor at your own expense.

Second, your employer must have the panel listed posted somewhere on location where the employee is expected to see them.  In most instances, it is likely an employee break room.  Second, the employee must have signed an acknowledgement when hired AND right after the injury.

Another provision of the law regarding panel doctors that is not readily understood by injured workers is the fact that if a panel list exists, you are free to treat with whichever doctor you choose on that list.  Your employer can not dictate which doctor you treat with on that list.  If you are unhappy with a panel provider, you are free to select another doctor on the panel list.

It is equally important to understand that even if all obligations are met and you treat with the panel physicians/providers, on the 91st day after your injury date, you are then free to treat with whatever provider you wish and as long as the treatment is reasonable necessary, the insurance carrier must pay.  

Finally, and a very important point as well, if you receive a Notice of Compensation Denial, in which your employer/insurance carrier is denying you workers’ compensation benefits, then the panel provision does not apply.  If your injury is denied, you can treat from day one with a doctor of your choice.

These rules can be complex and confusing.  If you have any questions or would like to consult with us regarding your work injury, simply give us a call at 717-632-4656 or toll free at 1-877-632-4656.

Mooney & Associates represents injured workers in South Central Pennsylvania including Franklin County, Cumberland County, Adams County, Dauphin County, York County, and Fulton County.