If you’ve been hurt on the job in Pennsylvania, the state’s workers’ compensation laws exist to make sure you’re not left without income or medical support. This guide breaks down how the system works, who qualifies, and what benefits you may be entitled to after a workplace injury or occupational illness.

Does Pennsylvania Require Employers to Carry Workers’ Comp Insurance?

Yes. Under the Pennsylvania Workers’ Compensation Act, nearly all employers must carry workers’ compensation insurance, even if they only employ one person. This includes full-time, part-time, and seasonal workers. Employers may obtain insurance through a private insurer or the State Workers’ Insurance Fund (SWIF). Some large companies may be self-insured if approved by the state.

Failure to carry this insurance is a criminal offense in Pennsylvania. Injured workers are still entitled to benefits, and the employer may face severe penalties.

Who Is Covered Under the Law?

Most employees are covered from their first day on the job. This includes those in:

• Construction
• Manufacturing
• Healthcare
• Education
• Retail
• Office jobs

Some workers are exempt, including certain agricultural workers, domestic servants, and independent contractors. However, if a worker is misclassified as an independent contractor, they may still qualify for benefits under the law.

What Injuries Are Covered?

Pennsylvania workers’ comp covers injuries and illnesses that arise in the course and scope of employment. This includes:

• Sudden injuries (slips, falls, equipment accidents)
• Repetitive strain injuries (like carpal tunnel)
• Occupational illnesses (like lung disease or hearing loss)
• Aggravations of pre-existing conditions

Injuries during breaks, while commuting, or due to intoxication may not be covered, but it depends on the situation. Always report your injury to your employer right away and see a medical provider.

Steps to File a Workers’ Comp Claim in Pennsylvania

1. Report your injury to your employer within 21 days, but no later than 120 days.
2. Seek medical care. For the first 90 days, you may need to see a provider approved by your employer.
3. Your employer or their insurance company should file a First Report of Injury (FROI) with the Pennsylvania Department of Labor and Industry.
4. If your claim is approved, you’ll receive a Notice of Compensation Payable.
5. If your claim is denied, you’ll receive a Notice of Compensation Denial and can appeal the decision.

You can appeal a denied claim through the Workers’ Compensation Office of Adjudication and request a hearing before a workers’ compensation judge.

What Benefits Are Available?

If your claim is approved, you may be entitled to several types of compensation:

• Medical benefits: Covers all necessary and reasonable treatment related to the injury or illness.
• Wage-loss benefits: If you miss more than 7 days of work, you may receive about two-thirds of your average weekly wage.
• Specific loss benefits: For permanent loss of a body part, sight, or hearing.
• Disfigurement benefits: For permanent scarring or disfigurement to the head, neck, or face.
• Death benefits: Paid to surviving dependents of workers who die as a result of a work-related injury.

All benefits are generally tax-free.

What If You’re Partially Disabled?

Workers who return to work in a lower-paying position due to their injury may be eligible for partial disability benefits. These are typically available for up to 500 weeks. If your condition worsens, you may reapply for total disability benefits.

Permanent Impairment and the 104-Week Rule

After receiving total disability benefits for 104 weeks, an employer may request that the injured worker undergo an Impairment Rating Evaluation (IRE). If the rating is under 35%, the worker may be reclassified as partially disabled and benefits may be capped at 500 weeks.

You have the right to contest an IRE determination and should speak with a workers’ comp attorney if this applies to you.

Can You Be Fired While on Workers’ Comp?

Technically, yes—but not for filing a claim. Pennsylvania law prohibits retaliation for seeking workers’ compensation. However, your employer can still terminate you for unrelated reasons (such as company downsizing or performance issues).

If you suspect you were fired because of your injury, you may have grounds for a retaliation claim under employment law.

What Is the Statute of Limitations for a Claim?

You must notify your employer within 120 days of your injury. In most cases, claims must be filed within three years of the date of injury to preserve your rights. Don’t delay in reporting or filing—your ability to receive benefits depends on meeting these deadlines.

Third-Party Claims in Pennsylvania

If a third party (such as a driver, subcontractor, or equipment manufacturer) contributed to your injury, you may also be able to file a personal injury lawsuit in addition to your workers’ compensation claim. This can help you recover damages not covered under workers’ comp, such as pain and suffering.

Do You Need a Lawyer to File a Claim?

You’re not legally required to have an attorney to file a workers’ compensation claim, but it’s often helpful—especially if:

• Your claim is denied or delayed
• You’re being pressured to return to work early
• You’re receiving less than expected
• You may need long-term care or surgery
• Your employer does not have insurance

An experienced workers’ compensation attorney can help protect your rights and ensure you receive everything you’re entitled to under the law.

Legal Help for Injured Workers in Pennsylvania

• PA Department of Labor & Industry – Workers’ Compensation Office
• Pennsylvania Bar Association Lawyer Referral Service
• Legal Aid of Southeastern PA
• Workers’ Compensation judges directory
• Certified Workers’ Comp attorneys near you

If you’re feeling overwhelmed, you’re not alone. Filing a claim can feel confusing, especially when you’re recovering from an injury. Don’t be afraid to ask questions or get legal advice early in the process.