What Are “Specific Loss Benefits” in a Workers’ Compensation Claim?

Getting injured at work may only mean a sore back or maybe a sprained ankle to some of us, but many workers have to consider more severe injuries, such as the loss of a limb or loss of vision. This sort of extreme injury is known as a specific loss, and in Pennsylvania (and many other states), there are specific laws in place in order to ensure that the injured worker is financially covered in the instance of such an accident.

Workers’ compensation protects the employee when they are hurt while working, but the process and system can be complicated, and companies or employers may try to look for the easiest or cheapest way out. That is why it is important to know your rights, and understand that if you are injured and are concerned about compensation, you should contact a Harrisburg workers’ compensation attorney.

What are specific loss benefits?

Specific loss benefits in Pennsylvania refer to a type of compensation available under the state’s workers’ compensation system. These benefits are designed to provide financial support to workers who have suffered the loss of certain body parts or functions due to a work-related injury or occupational disease. Specific loss benefits are separate from wage loss benefits, which are intended to replace a portion of an injured worker’s lost wages.

What types of specific loss benefits are there?

In Pennsylvania, specific loss benefits are categorized into two main types:

Scheduled specific loss: Scheduled specific loss benefits are awarded for the loss of specific body parts or functions that are listed in the Pennsylvania Workers’ Compensation Act. These benefits are generally calculated based on a predetermined number of weeks of compensation for each specific loss.

The specific body parts and the corresponding number of weeks may vary, but common examples include:

• Loss of a thumb: Sixty-six and two-thirds per centum of wages during one hundred weeks
• Loss of a hand: Sixty-six and two-thirds per centum of wages during three hundred thirty-five weeks.
• Loss of vision in one eye: Sixty-six and two-thirds per centum of wages during two hundred seventy-five weeks.

In addition to scheduled loss payments, the Act also allows for a discretionary award of benefits for disfigurement caused by an injury, as long as the disfigurement is from the neck up. Common examples include burns, lacerations or surgical scarring to the neck or face area.

How do I qualify for specific loss benefits?

The Pennsylvania Department of Labor and Industry states “if you have lost the permanent use of all or part of your thumb, finger, hand, arm, leg, foot, toe, sight, hearing or have a serious and permanent disfigurement on your head, face or neck, you may be entitled to a specific loss award.”

Specifically, to qualify for specific loss benefits in Pennsylvania, certain criteria must be met:

• Work-related injury: The injury or condition must be work-related, meaning it must have occurred in the course of employment or as a result of the job.
• Specific loss: The injury must result in the loss of use of a body part for all intents and purposes.
• Medical documentation: A medical professional must provide documentation and evidence of the specific loss, including the extent of the impairment and its impact on the worker’s ability to perform their job.
• Filing a claim: To start the process, the injured worker must file a workers’ compensation claim with their employer’s insurance carrier. It’s crucial to report the injury promptly to ensure eligibility for benefits. In Pennsylvania, a worker must file their claim “no later than 120 days after the injury for compensation.” It’s essential to report the injury and initiate the claims process within the specified timeframe to preserve your rights to benefits.

What can I do if my benefits are denied?

In some cases, disputes may arise regarding the eligibility or amount of specific loss benefits. If an injured worker’s claim is denied or they believe they are not receiving the appropriate compensation, they have the right to appeal the decision through the Pennsylvania workers’ compensation system. This often involves administrative hearings and legal proceedings.

How can a Harrisburg workers’ compensation attorney help?

At KBG Injury Law, we understand the complexities that workers face when navigating the workers’ compensation system, particularly in cases involving specific loss claims. This is why we highly recommend seeking guidance from an experienced workers’ compensation attorney. By doing so, you can significantly increase your chances of receiving the appropriate compensation for your specific loss.

In Pennsylvania, specific loss benefits play a pivotal role in the state’s workers’ compensation framework. They serve as a crucial lifeline for workers who have endured injuries resulting in the loss of specific body parts or functions. Familiarizing yourself with the eligibility criteria and the intricacies of the calculation process is paramount for injured workers who are in pursuit of fair compensation and financial stability throughout their recovery.

Our dedicated team at KBG Injury Law is committed to providing the support and expertise needed to navigate the complicated legal process. We believe that every injured worker deserves the maximum compensation to which they are entitled under the law. If you’re facing a specific loss claim or any other workers’ compensation matter, don’t hesitate to reach out. We’re here to help you through every step of the process. To schedule a free consultation, contact us to learn more about your rights. Our team has locations in Harrisburg, Lancaster, Gettysburg, Hanover, and York, and we are ready and available to answer your questions and concerns about workers’ compensation and specific loss benefits.