Pennsylvania workers’ compensation benefits cover all reasonable medical treatment for a job-related injury, replace a portion of lost wages up to a maximum of $1,394.00 per week for injuries in 2026, and pay set amounts for permanent losses like amputations or death.1Commonwealth of Pennsylvania. Statewide Average Weekly Wage (SAWW) You do not have to prove your employer did anything wrong. You do, however, have to meet strict deadlines and follow rules about which doctor you see, or you can lose benefits you would otherwise be entitled to.
Who Is Covered
Every Pennsylvania employer with at least one employee must carry workers’ compensation insurance, and coverage starts the moment you begin working. There is no waiting period and no minimum hours.2Commonwealth of Pennsylvania. LIBC-200 Employer Information A handshake deal counts the same as a written contract.
Independent contractors are generally excluded, but Pennsylvania presumes you are an employee unless the hiring party can show both that you are free from control over how the work is done and that you run your own independent trade or business.3Commonwealth of Pennsylvania. Employee or Independent Contractor If someone sets your hours, supervises your work, and supplies your tools, you are likely covered no matter what your paperwork calls you.
The Act’s definition of injury is broad. It reaches sudden workplace accidents, occupational diseases from long-term exposure, and aggravations of conditions you already had, so long as the harm arose from your job.4Pennsylvania General Assembly. Pennsylvania Code 77 P.S. 411 – Injury, Personal Injury, and Injury Arising in the Course of His Employment Defined
Medical Benefits and the 90-Day Doctor Rule
The insurer must pay for all reasonable and necessary treatment tied to your work injury: doctor visits, surgery, hospital stays, prescriptions, physical therapy. Providers cannot bill you for care related to a compensable injury.
The catch is in the first 90 days. If your employer has posted a compliant list of panel providers, you have to pick a doctor from that list for the first 90 days after your initial visit. The list must name at least six providers, including at least three physicians, all geographically accessible to you.5Legal Information Institute. 34 Pa. Code 127.751 – Employer’s Option to Establish a List of Providers You can switch between providers on the list during that window, and emergency care is always exempt. After 90 days you can see any doctor you want.
If your employer never posted a proper list, the restriction never applied, and you were free to pick your own doctor from day one.6Commonwealth of Pennsylvania. Physicians List Defined Going off-panel during those first 90 days when a valid list exists is one of the quickest ways to end up paying your own medical bills.
Wage Loss Benefits
When your injury keeps you from earning what you did before, workers’ comp replaces part of that lost income. Your pre-injury average weekly wage puts you in one of four brackets, all tied to the statewide average weekly wage. For 2026 injuries:1Commonwealth of Pennsylvania. Statewide Average Weekly Wage (SAWW)
- Average weekly wage above $2,091.00: capped at $1,394.00 per week.
- $1,045.51 to $2,091.00: 66⅔% of your average weekly wage.
- $774.44 to $1,045.50: a flat $697.00 per week.
- $774.43 or less: 90% of your average weekly wage.
Total Disability
Total disability benefits apply when you cannot do any work. Payments continue as long as the disability lasts. After 104 weeks of total disability, though, the insurer can request an Impairment Rating Evaluation using the AMA Guides. If the rating comes in below the required threshold, your benefits convert automatically from total to partial disability, which carries a cap.
Partial Disability
Partial disability covers you when you can work but earn less than you did before. The weekly payment equals 66⅔% of the difference between your old wages and your current earnings. Partial disability has a hard ceiling of 500 weeks, just under ten years, after which wage-loss payments stop even if you are still earning less.
Specific Loss Benefits
Permanent physical losses get their own benefit, paid on top of any wage loss and without any requirement to show missed work. Each loss has a fixed number of weeks at 66⅔% of your pre-injury wages:7New York Codes, Rules and Regulations. Pennsylvania Code 77 P.S. 513 – Schedule of Compensation for Disability From Permanent Injuries of Certain Classes
- Hand: 335 weeks
- Forearm: 370 weeks
- Arm: 410 weeks
- Foot: 250 weeks
- Lower leg: 350 weeks
- Leg: 410 weeks
- Eye: 275 weeks
- Thumb: 100 weeks
- Index finger: 50 weeks
Occupational hearing loss from long-term noise is measured by binaural impairment and multiplied by 260 weeks. Hearing loss from a single traumatic event uses a separate formula depending on whether one or both ears are affected. Serious permanent disfigurement of the head, face, or neck is also compensable as a specific loss.
Death Benefits
If a work injury or illness causes death within 300 weeks, the Act pays ongoing benefits to surviving dependents, with the percentage of the worker’s wages depending on who is left behind:8Pennsylvania General Assembly. Chapter 3 – Workers’ Compensation Act
- Surviving spouse, no children: 51% of wages, capped at the statewide average weekly wage.
- Surviving spouse with one child: 60% of wages.
- Surviving spouse with two or more children: 66⅔% of wages.
- One child, no surviving spouse: 32% of wages.
- Two children, no surviving spouse: 42% of wages, rising with additional children up to 66⅔% for six or more.
- Dependent parent (no spouse or children): 32% if partially dependent, 52% if fully dependent.
All death benefits are capped at the statewide average weekly wage in effect at the time of injury. The employer or insurer also pays up to $7,000 in burial expenses directly to the funeral home.9New York Codes, Rules and Regulations. Pennsylvania Code 77 P.S. 561 – Persons Entitled to Compensation on Death of Employe; Amounts
The Deadlines That Can End Your Claim
Three dates matter. Report the injury to your employer within 21 days and your benefits are retroactive to the date of injury. Report between day 22 and day 120 and you can still collect, but only from the date you gave notice forward. Wait past 120 days and you lose the right to compensation entirely.10New York Codes, Rules and Regulations. Pennsylvania Code 77 P.S. 631 – Knowledge of Employer; Notice of Injury to Employer; Time for Giving Notice; Exception
Verbal notice to a supervisor technically counts, but proving it happened months later is a different fight. Put it in writing and keep a copy.
If your employer or insurer denies the claim or does nothing, you have three years from the date of injury to file a formal claim petition.11Commonwealth of Pennsylvania. LIBC-100 WC and The Injured Worker Pamphlet Miss that three-year window and even the strongest claim is gone.
On the insurer’s side, the first payment must go out no later than 21 days after the employer learns of your disability.12Commonwealth of Pennsylvania. Calculating 21-Day Compliance Within that same 21 days the insurer has to accept the claim, deny it, or issue a temporary notice that extends the investigation to 90 days while payments start.13Commonwealth of Pennsylvania. The Flow of a Pennsylvania Workers’ Compensation Claim
If Your Claim Is Denied
A denial is not final. You file a claim petition and get a hearing before a workers’ compensation judge, who takes testimony, reviews medical evidence, and issues a binding decision. The three-year deadline from the date of injury applies to filing that petition.11Commonwealth of Pennsylvania. LIBC-100 WC and The Injured Worker Pamphlet If you lose, you can appeal to the Workers’ Compensation Appeal Board, with further review available in Commonwealth Court on legal errors.14Commonwealth of Pennsylvania. File an Appeal of a Workers’ Compensation Judge’s Decision
Insurers also use this process to cut off benefits once they’re flowing. If the insurer wants to reduce or stop your payments, it has to file its own petition and prove the change is justified. Common fights involve whether you can return to work, whether a job offer fits your restrictions, and whether an Impairment Rating Evaluation justifies converting total disability to partial.
What Your Attorney Can Charge
Attorney fees in Pennsylvania workers’ compensation cases are capped at 20% of the amount awarded, and a workers’ compensation judge has to approve the fee. The same 20% ceiling covers lump-sum settlements.15Pennsylvania General Assembly. Pennsylvania Code 77 P.S. 998 – Counsel Fees; Agreements Between Attorney and Employe Attorneys work on contingency, so there is nothing to pay up front and the fee comes out of what you recover.