Philadelphia Workers' Compensation Specific Loss Benefits

Although the specifics of workers’ compensation laws can vary to some degree from one state to another, in most cases, an injured worker does not have to prove the accident that caused their injuries resulted from someone else’s negligence to be eligible for workers’ compensation benefits. They must simply prove that their accident genuinely qualifies as a work-related injury that did not occur because they were unreasonably negligent (such as being intoxicated while at work). This is one of many ways workers’ compensation cases differ from other types of personal injury cases.

If you are in this situation, do not hesitate to contact Gross & Kenny, LLP. During a confidential consultation, we can discuss Philadelphia workers’ compensation specific loss benefits and how these benefits may play a role in your claim. Call today to get started. We proudly serve Philadelphia and the surrounding areas, such as Bustleton and South Philadelphia.

Specific loss benefits exist for those who must undergo amputation of an arm, leg, toe, or finger as a result of a work injury. Additionally, specific loss benefits are available to those who lose more than 50 percent of their functioning in any single body part, as well as workers who suffer facial scarring or disfigurement. Unfortunately, many of these same injured employees may be misled into believing they do not qualify for anything other than traditional workers’ compensation benefits.

Working with Insurance Companies

Workers’ compensation insurance companies theoretically serve to provide injured workers with the full amount of compensation they deserve when they are harmed on the job. Unfortunately, insurance adjusters are often encouraged to protect their employers financially by offering as little money as possible to claimants. Because it is unlikely that an insurer will affirmatively provide information to a claimant about the potential availability of specific loss benefits, it is imperative that injured employees learn – and then enforce – their rights.

How are Benefits Determined?

An amputated toe will generally involve a shorter recovery period than an amputated arm. To that end, the Pennsylvania workers’ compensation act sets forth the fact that different body parts have differing importance in an employee’s job. Under the statute, workers’ compensation benefits are calculated based upon an average weekly wage, and that rate is offered for a predetermined number of weeks based upon the body part which has been amputated or rendered nonfunctional.

Understanding the degree to which you may or may not be eligible for specific loss benefits when filing a workers’ compensation claim can be difficult if you are not familiar with the laws that apply to your case. This is one of several reasons to hire an attorney. At Gross & Kenny, LLP, our Philadelphia specific loss benefits attorneys will ensure you are pursuing an appropriate workers’ compensation when you file a claim. If the insurance company won’t immediately offer the payout you deserve, we are prepared to negotiate aggressively on your behalf.

At the lesser end of the benefits spectrum is the loss of a little finger, which is entitled to a healing period of six weeks and 18 weeks of paid wages. Similarly, any toe other than the big toe has a six-week healing period and a 16-week paid benefits period. Severe injuries to the lower body – such as an amputated foot or leg – have a longer, 25-week healing period and 250 and 410 weeks of paid benefits, respectively. An amputated arm also receives 410 weeks of paid benefits but offers a slightly shorter healing period of 20 weeks. Although there is no set healing period for the disfigurement of the face, head, or neck, these injuries are generally entitled to 275 weeks of wage compensation.

Philadelphia specific loss benefits attorneys note that a worker receiving payments under the specific loss benefits framework outlined in the Pennsylvania workers’ compensation act will not see a disruption in benefits collected from a traditional workers’ compensation claim. Instead, an award of specific loss benefits is in addition to workers’ compensation benefits, as an acknowledgment that the loss of a limb represents a lifelong disability that can never be fully restored.

Importantly, an injured worker who returns to work early is still entitled to specific loss benefits for the duration of the healing period dictated by the statute. In such a scenario, an employee need only prove that his or her limb was amputated or rendered 50 percent nonfunctional in order to submit a claim for a specific loss.

The details above once again highlight the value of having legal representation when filing a workers’ compensation claim that involves a specific loss benefits request. These cases are often very nuanced. You need representation from a professional whose knowledge of the relevant laws can help them fully determine whether an insurance company is making a fair offer or lowballing you.

Additionally, it’s worth noting that the process of securing compensation after a workplace accident can involve a range of steps, including completing paperwork, investigating your accident, and corresponding with insurance adjusters. Don’t burden yourself with these responsibilities when you should be focusing on your recovery. Instead, hire a skilled attorney to handle your Philadelphia workers’ compensation specific loss benefits case while you get the rest and treatment you need in this difficult time.