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When Am I Covered by the Heart and Lung Act?

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When am I covered by the Heart and Lung Act?

When Am I Covered by the Heart and Lung Act?

The Pennsylvania Heart and Lung Act was designed to provide special benefits to certain categories of civic workers, like police officers and firefighters, whose jobs are more dangerous or difficult than that of the average worker. Legislators enacted this law, also called the Enforcement Officers Disability Benefits Law, in 1935, although it was amended in 2006 to include sheriffs and deputy sheriffs.

If a civic worker who falls into one of the categories defined by the legislature suffers an injury in the line of duty, they will receive their full pay, not including vacation time or overtime. For comparison, injured workers who fall under the workers’ comp law receive two-thirds of the average weekly compensation.

What Conditions Must Be Met to Receive Heart and Lung Act Benefits?

An injured civic worker could qualify for Heart and Lung Act benefits if:

  • Their injury occurred in the performance of duties
  • Their injury is temporary
  • Their injury prevents them from performing the essential duties of their job
  • Their employer can not or will not accommodate their injury by placing them in a lighter duty position

What Benefits Am I Entitled To?

Anyone who qualifies for Heart and Lung benefits receives their full base pay and payment of any medical expenses. Base pay does not include vacation pay, overtime or any income from a second job. Heart and Lung benefits are not taxable, with some limitations.

An injured worker will continue to receive Heart and Lung benefits until they are able to return to their job, their injury becomes permanent or their employer can show that their injury is of “indefinite duration,” a very loose standard that employers often try to use to remove employees from of Heart and Lung benefits.

Even if no longer eligible for Heart and Lung benefits, an injured employee would still be eligible for workers’ compensation.

Also, if you become ill while you are receiving Heart and Lung Act benefits and need sick leave, it would not be counted as time off for the Heart and Lung Benefits.

Who Qualifies for Heart and Lung Act Benefits?

Pennsylvania civic workers in various areas of law enforcement, correctional activities and firefighting may be eligible to receive Heart and Lung benefits:

  • All firefighters who work for a city, a county, a borough or a township or a town
  • All police officers who work for a city, a county, a borough or a township or a town
  • Sheriffs
  • Deputy sheriffs
  • Members of the State Police Force
  • Park guards
  • Special agents of the Office of Attorney General
  • Drug enforcement agents of the Office of Attorney General
  • Psychiatric security aides for the Department of Public Welfare
  • Psychiatric security aides for the Department of Corrections
  • Parole agents
  • Correction employees whose primary duties involve guarding or caring for inmates
  • Liquor Control Board investigators
  • Liquor Control Board enforcement officers
  • Delaware River Port Authority police

Volunteer firefighters, EMTs and rescue personnel are not eligible to receive Heart and Lung benefits.

When Am I Covered by the Heart and Lung Act?

You are covered by the Pennsylvania Heart and Lung Act if you are a qualified civic worker, such as a police officer or firefighter, who has been injured in the line of duty. You will receive workers’ compensation benefits paid through your employer. Your employer will also pay additional monies so you receive your full base salary.

If you are a qualified worker and your injury is temporary, you will receive Heart and Lung Act benefits until you are able to return to work. If you have been permanently injured, you may be eligible for workers’ compensation or other benefits.

The standard for determining eligibility for Heart and Lung Act benefits is stricter than determining the eligibility for workers’ compensation benefits.

  • To be eligible for workers’ compensation benefits, a worker must be injured “in the course of employment.” For example, a worker who is injured when they trip over an object in the dark on the way to the restroom at work qualifies for workers’ compensation benefits.
  • The regulations for Heart and Lung Act coverage are more stringent. The worker must suffer an injury or contract a disease during the “performance of duties.”

Performance of duties involves an essential or obligatory function or task that is contingent on being a firefighter, a police officer or one of the other positions listed above. A firefighter or police officer may also be eligible for Heart and Lung benefits if the injury was the result of an event that occurred during an official fire or police response.

Court decisions over the years have tended to use liberal definitions of “injuries” or “diseases” when applying the compensability standard.

  • If an alarm went off in a firehouse, and a firefighter tripped while rushing to their engine and broke an arm, they may be eligible for Heart and Lung Act benefits.
  • If, however, that same firefighter ended their shift and while walking to their car in the parking lot, tripped and broke their arm, they would not be eligible for Heart and Lung Act benefits. This is because the injury did not arise from their status as a firefighter or occur during a fire response.
  • If the firefighter, however, was injured in the parking lot while on their way into work in the morning, they may qualify for Heart and Lung benefits.
  • A police officer who suffers an injury while exercising in preparation for an annual mandated physical may qualify for Heart and Lung benefits.
  • A police officer injured while training with a service revolver may also qualify, whether they were training at work or at home.

The Interplay Between the Heart and Lung Act and Workers’ Compensation

Eligibility for Heart and Lung Act benefits may be more complicated in some situations. Since employers and their insurance carriers may contest a complex injury that involves the Heart and Lung Act, it is in your best interest to work with a personal attorney.

For instance, a firefighter who develops asthma can apply for Heart and Lung Act benefits because they can reasonably argue that their condition arose from their status as a firefighter. Their employer will likely contest this and argue that their asthma did not result from their obligatory or essential duties.

A firefighter who develops asthma can apply.

When an employer denies an injured worker access to Heart and Lung benefits, they are obligated by law to give them a due process hearing. Unfortunately for an injured worker, however, the due process hearing is stacked against them.

  • First, there are no set guidelines on how to conduct a due process hearing other than it should conform to normal legal procedures. Every entity has its own set of guidelines.
  • Second, the employer only needs to inform the injured civic worker of the time and the place of the hearing and does not have to tell them anything about the guidelines.
  • Third, the hearing will take place in front of a group of people who work for the employer and not independent adjudicators.

Working with an attorney who understands the interplay between workers’ compensation and the Heart and Lung Act can provide many advantages to a qualifying civic worker.

For instance, an injured worker receiving Heart and Lung Act benefits is actually still receiving their workers’ compensation benefits. In this situation, however, those benefits are paid directly to the employer who uses them to offset the cost of paying the injured worker their full salary.

When employers or insurance carriers try to limit claims that concern work-related injuries, this creates an opportunity for a lawyer to transfer the claim to a workers’ compensation forum. Workers’ compensation hearing rules are more stringent and involve soliciting formal testimony from medical experts and other witnesses and require adjudication by an independent workers’ compensation judge.

Additionally, as decided by the Pennsylvania Commonwealth Court in 2010, the attorney’s firm covers the cost for medical testimony, and the employer’s insurance carrier must repay this cost to them, along with their attorney fees, if the attorney succeeds.

This means that the injured worker is, essentially, not paying for legal counsel nor for expert medical testimony. Instead, the employer or their insurance carrier must pay for them from the workers’ compensation fees they receive when the injured worker is on Heart and Lung benefits.

Therefore, it is in your best interest to work with a personal attorney who understands workers’ compensation law and how it interplays with the Heart and Lung Act.

Are There Occasions When It May Be Better to Accept Workers’ Compensation Than Heart and Lung Benefits?

Possibly. When an injured civic worker receives Heart and Lung Act benefits, they receive their full salary, excluding overtime, vacation pay and any income from a second job. Under workers’ compensation, all these additional revenue streams are taken into consideration. The only drawback is that under Pennsylvania’s workers’ compensation law, there is a limit to how much an injured worker can receive in wage loss benefits each week. Currently, it is $1,049.

It makes sense to sit down with your attorney who can help you determine which benefit may be of greater help to you while you’re recovering from a temporary injury.

What About My Vacation Pay and Regular Benefits?

Currently, the Heart and Lung Act does not explicitly say that your employer must reimburse you for vacation pay or regular benefits while you are receiving Heart and Lung benefits.

What about my vacation pay and regular benefits?

There is a good chance, however, that the collective agreement that your union signed with your employer will keep these benefits active for you. Check with your union or look over the collective bargaining agreement to see what your rights are if you are on or are considering applying for Heart and Lung benefits.

Can My Employer Use My Sick Time or Vacation Time to Account for When I’m Off the Job?

No. The Heart and Lung Act says that an employer may not use any sick leave or vacation time to account for missed time while an injured worker is receiving Heart and Lung Act benefits.

What If I Have a Permanent Injury?

If your injury is permanent or if your employer has succeeded in showing that your injury is of “indefinite duration,” you will lose Heart and Lung benefits. You are, however, still eligible for workers’ compensation benefits.

If you suffer a permanent injury and your employer tries to convince you to accept retirement with a pension or social security benefits, DO NOT accept them immediately. It is very important that you speak to your attorney first. If you accept the pension or social security benefits, this ends your ability to collect workers’ compensation benefits.

Work-related injuries of a permanent nature often involve lump-sum settlements. You could be denying yourself access to important funds for yourself and your family if you act too quickly. It’s also possible that you still may be eligible to receive a pension or Social Security benefits after concluding a workers’ compensation lump sum payment.

Should I hire a personal lawyer?

Should I Hire a Personal Lawyer?

Yes. Having a personal lawyer gives you a much better chance of acquiring all the benefits to which you are entitled. Often, an injured civic worker decides to use the lawyer that represents the union. While all attorneys do their very best to represent their clients, the reality is that union attorneys may not have as much experience in workers’ compensation claims or Heart and Lung Act benefits or in the way they interact.

Unions often sign agreements with legal firms based on price discounts. This can be particularly advantageous for the union in terms of union issues. When it comes to issues like workers’ compensation or Heart and Lung benefits, however, it can work against the best interest of union members. In this kind of situation, the lawyer assigned to work a case is often a junior member of the firm with relatively little legal experience, let alone experience in these complicated issues.

Hiring a personal attorney means you will be working with someone with expertise in these matters who can give your case more of their attention. Hiring a personal attorney doesn’t always guarantee success, but it dramatically increases the likelihood of a positive outcome.

Do You Have Questions?

Determining how and when you are eligible for Pennsylvania Heart and Lung Act coverage can be challenging, especially if your employer is saying you do not qualify for benefits or is trying to delay or deny benefits you feel you are qualified for.

If you have been injured at work, contact KBG Injury Law for legal representation in your Heart and Lung Act claim or workers’ compensation claim. The attorneys at KBG Injury Law can represent you to give you the best chance of securing benefits for your injuries.

Contact KBG Injury Law for legal representation in your Heart and Lung Act claim.

During this challenging time, our attorneys are advocating more than ever. While our physical offices are closed, we are all working remotely to ensure you still get the Results You Deserve. To all of our current clients, you can connect with us the same way you always do via email, phone, fax or text. To all of our prospective clients, the best way to get in touch with us is by using our contact form or by calling (800) 509-1011