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Can I Collect Workers’ Compensation & Heart and Lung Act Benefits?

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Can I Collect Workers' compensation & Heart and Lung Act Benefits?

Can I Collect Workers’ Compensation & Heart and Lung Act Benefits?

The Pennsylvania Heart and Lung Act was first enacted in 1935 as the Enforcement Officer Disability Benefits Law and amended in 2006 to cover sheriffs and deputy sheriffs. This law offers special benefits to first responders like firefighters and police. The law aims to provide first responders, whose jobs are often far more difficult and dangerous than the average worker’s occupation, with special benefits when they have been injured while on official duty.

The injury must be temporary, and the benefits last until the individual returns to work or their injury is classified as permanent. In the latter case, the first responder may then be covered by their workers’ compensation rights.

Since workers’ compensation law covers almost all Pennsylvania workers, state employees who are eligible to receive Heart and Lung benefits receive them in lieu of workers’ compensation benefits.

Who Qualifies for Benefits Under the Heart and Lung Act?

The Heart and Lung Act covers a variety of Pennsylvania employees who work in law enforcement, correctional activities or as firefighters. Qualifying employees include:

  • Police Officers (City, County, Borough, Township or Town)
  • Firefighters (City, County, Borough, Township or Town)
  • State Police
  • Sheriffs
  • Deputy Sheriffs
  • Parole Agents
  • Drug Enforcement Agents
  • Special Agents Who Work for the Office of the Attorney General
  • Psychiatric Security Aides Who Work for the Department of Public Welfare or the Department of Corrections
  • Correction Employees Whose Primary Duties Involve Taking Care of Inmates
  • Liquor Control Board Enforcement Officers or Investigators
  • Members of the Delaware River Port Authority Police

When am I covered by the Heart and Lung Act?

When Am I Covered by the Heart and Lung Act?

If you work in one of the above categories for the state of Pennsylvania, and you are injured while performing an official duty, you may be eligible to be compensated under the Heart and Lung Act.

The eligibility requirements for Heart and Lung Benefits are more specific than those to qualify for workers’ compensation. You must be performing an “official duty” when you’re injured to qualify.

For instance, if an officer is assisting in an arrest, trips and injures themselves, they would be eligible. But if that same officer trips in the department’s parking lot after work and suffers an injury, they would not be eligible for Heart and Lung Benefits, although they could be covered by workers’ compensation.

It’s important to remember that Heart and Lung Act benefits only cover temporary injuries. Workers’ compensation covers temporary and permanent injuries.

How Much Can You Collect in Benefits Under the Heart and Lung Act?

An injured worker who is eligible for Heart and Lung Act benefits receives 100% of their regular salary while they are temporarily off-duty because of an injury or illness. Your employer pays medical expenses related to your injury. These benefits do not include compensation for overtime pay and do not cover wages from a second job. Death benefits are not included.

Like workers’ compensation benefits, Heart and Lung wage benefits are not taxable, so neither federal nor state taxes are deducted. FICA and Medicare taxes are deducted for the first six months, but deductions stop after that.

When an injured worker is eligible to receive Heart and Lung benefits, they are also considered eligible to receive workers’ compensation benefits.

If you are a worker in Pennsylvania who will be receiving Heart and Lung Act benefits because of an on-the-job injury, you will also be receiving workers’ compensation. Your payments for workers’ compensation will be sent to your employer and your employer will use these funds to cover the difference between workers’ comp benefits, which only cover two-thirds of your average weekly wage, and your full salary.

In Pennsylvania the maximum amount available as an average weekly wage for 2019 is $1,046 a week.

You will continue to receive benefits if:

  • Your injury is temporary.
  • The injury stops you from performing the essential duties of your job.
  • Your employer is unwilling to or cannot change your job’s official duties to accommodate your medical restrictions.
  • You continue to be eligible to receive Heart and Lung Act benefits.

Does the Extremity of the Disability Matter in Terms of Receiving Benefits?

No. The Heart and Lung Act covers all injuries to any body part suffered while performing official duties. Despite the name of the Act, you receive Heart and Lung benefits for all injuries, not just those to your heart or lungs. Mental illnesses and injuries developed over time such as carpal tunnel syndrome also apply, as long as you demonstrate they are related to official duties.

How Long Does It Take to Find Out If You’re Eligible?

With workers’ comp, when an injured employee suffers a work-related injury and reports it to their employer, the employer has 21 days to decide if the injured worker is eligible to receive workers’ compensation benefits. If the employer denies the employee these benefits, this begins the workers’ compensation claim and appeal process.

Determining eligibility for Heart and Lung benefits is slightly different. An injured worker should report that injury to their employer as soon as possible. The employer will then ask the injured worker to give them a statement that details how the injury occurred, why they think the injury is only temporary and why it will prevent them from doing the essential duties of their job.

The employer will then ask a representative to investigate the incident. When the investigation is complete, the representative will issue a written report and give it to your employer and to you.

If the investigator deems you are eligible to receive Heart and Lung benefits, you will receive payments that cover the first workday after you suffered the injury until you return to work or a due process hearing deems you ineligible to receive benefits. If the report suggests your injury does not qualify you for Heart and Lung benefits, you will be notified of why your claim was denied and informed of the appeals process.

Unlike the workers’ compensation process, there is no set guideline for when a determination of eligibility for Heart and Lung benefits should be done. In 2017, the police union and the state of Pennsylvania agreed that the timeframe should be the same one used for workers’ compensation — 21 days.

Eligibility for injured workers in other categories may not happen as quickly, although most employers try to stick to the 21-day time limit.

Does the injury have to be severe to qualify for Heart and Lung benefits?

Does the Injury Have to Be Severe to Qualify for Heart and Lung Benefits?

No. Any injury which requires an employee to be off the job temporarily qualifies for Heart and Lung benefits in Pennsylvania. This is unlike benefits that may be available in other states, such as Virginia. In Virginia, state employees covered under their Heart and Lung Act must suffer heart or lung injuries specifically. Any other injury falls under workers’ compensation in Virginia.

This is not the case in Pennsylvania. In Pennsylvania, the idea behind Heart and Lung benefits is to aid Pennsylvania state employees financially while they are recovering from a temporary injury.

Can I Collect Workers’ Comp With Heart and Lung Act Benefits?

Technically, yes. As noted above, however, if you are eligible for Heart and Lung benefits, you receive them in lieu of workers’ compensation benefits. Your employer’s insurance company will send your workers’ compensation check to your employer, who will use those funds to help them match your regular salary.

It’s important to realize that employers and their insurance companies don’t like paying benefits of any kind and will do everything possible to deem you ineligible to receive Heart and Lung benefits or terminate them as soon as possible. They will argue your injury is not serious, or you suffered it off-duty or it is a permanent injury and thus does not qualify.

Your employer only needs to show that your injury may be of “indefinite duration” to rule you ineligible or argue that your Heart and Lung benefits need to stop.

You are still eligible to receive workers' compensation benefits.

Remember, if you are deemed ineligible to receive these benefits or if these benefits are terminated, you are still eligible to receive workers’ compensation benefits.

This is also why your employer and their insurance carrier often try to keep an injured worker in the dark about the interplay between the Heart and Lung Act and workers’ compensation. Working with an experienced workers’ compensation attorney who also understands the Heart and Lung Act gives you significant advantages in the way your claim is managed.

What If My Injury Is Caused by a Third Party?

If you are injured by a third party while you are on official duty — for instance, an on-duty police officer injured in a traffic accident — you are entitled to Heart and Lung benefits, and you can sue the driver of the vehicle that struck you for civil damages.

As a result of a 2018 Commonwealth Court decision, your employer cannot receive any part of a civil judgment in your favor to offset the Heart and Lung benefit payments made to you for wages or medical expenses. While an employer can seek compensation when an injured worker receiving workers’ compensation benefits is awarded a civil judgment, the court ruled this was not the case when an injured worker received Heart and Lung benefits.

Understanding the different ways that Heart and Lung and workers’ compensation interact with each other can be quite complicated. When you work with an experienced attorney who understands both the Workers’ Compensation Act and the Heart and Lung Act, they will help ensure that you receive all of the compensation to which you are entitled.

Why Is It Important for Me to Retain My Rights to Workers’ Compensation Benefits?

It is essential you retain your workers’ comp rights, especially when your employer is trying to terminate your Heart and Lung benefits. In another important case decided by the Pennsylvania Commonwealth Court in 2010, the ruling established that when attorneys representing an injured worker receiving Heart and Lung benefits successfully argue for the expansion, prolonging or protection of those rights in a workers’ compensation court, the 20% contingency fees normally paid only when an attorney wins a case must be paid from the workers’ compensation funds that your employer receives as part of the Heart and Lung payments.

Remember, the injured worker on Heart and Lung benefits never sees these workers’ compensation payments. The injured worker signs them over to their employer when they are on Heart and Lung benefits. So when an employer is required to pay an attorney’s fees as in the examples above, it means that the employer receives 20% less of the workers’ compensation fees.

Thus while you remain eligible for Heart and Lung benefits, your attorney’s fees will be paid by your employer when your case is adjudicated before a workers’ compensation court.

Therefore, it is never a good idea to opt-out of workers’ compensation benefits, even if you can do so.

What Happens If My Injury Is Considered Permanent?

If the injury that made you eligible for Heart and Lung benefits is ultimately ruled a permanent injury or one of “indefinite duration,” and your employer pushes you towards accepting early retirement or a disability pension, it is very important that you first speak to a workers’ compensation attorney who understands the connection between the Workers’ Compensation Act and the Heart and Lung Act.

If you accept early retirement or a disability pension, you may be disqualifying yourself from collecting workers’ compensation benefits for permanent injuries. These benefits can result in settlements for large sums. An experienced attorney will know how to coordinate the rights that you have under both Acts when dealing with an injury that could end your career.

Experienced attorneys will know how to help you achieve a settlement for a lump sum under workers’ compensation and can help you also secure a pension.

To Learn More, Contact the Experienced Attorneys at KBG Injury Law

Being injured on the job is frightening, especially if you are a firefighter, a police officer or other worker where physical mobility is an essential component of your work duties. If you are injured and cannot work, you may be eligible for Heart and Lung Act benefits or workers’ compensation. To determine what you are eligible for and to get help with your Heart and Lung Act or workers’ compensation claim, contact KBG Injury Law for a consultation.

Injuries caused by workplace incidents can be expensive to employers, and thus employers will sometimes try to avoid paying the benefits you may be eligible for under the Heart and Lung Act or workers’ compensation. If you feel your injuries have been misclassified or you are not getting your rightful benefits, contact KBG Injury Law for a consultation. The attorneys at KBG Injury Law specialize in workers’ compensation and workplace injuries and can help you determine your best course of action.

Our experienced attorneys will know how to help. Contact us today.

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