Bureau of Workers’ Compensation

Workers’ Compensation hearings

  • Held pursuant to the Pennsylvania Workers’ Compensation Act, 77 P.S. § 1 et seq., and regulations found in Title 34 of the Pennsylvania Code, Chapters 121 (relating to general provisions), 123 (relating to general provisions part II) and 127 (relating to workers’ compensation medical cost containment).
  • Conducted under the Special Rules of Administrative Practice and Procedure Before Workers’ Compensation Judges, 34 Pa. Code Ch. 131.
  • Location determined by the injured worker’s county of residence; field offices and satellite hearing locations exist throughout the state in each county.
  • Procedure varies by judge; serial hearings or one-day trial format used, at which testimony and evidence may be presented. Briefing schedule follows.
  • Appeals from decisions may be taken to the Workers’ Compensation Appeal Board.

Appeal hearings

  • Held pursuant to the Pennsylvania Workers’ Compensation Act, 77 P.S. § 1 et seq., and regulations found in Title 34 of the Pennsylvania Code, Chapters 125 (relating to workers’ compensation self-insurance), 127 (relating to workers’ compensation medical cost containment) and 129 (relating to workers’ compensation health and safety).
  • Conducted under the General Rules of Appellate Practice and Procedure, 1 Pa. Code Part II.
  • Location typically determined based upon nature of hearing and/or hearing officer assigned. Fee review hearings held at Bureau headquarters in Harrisburg; other appeal hearings may be held in field offices throughout the state.
  • Typically one-day trial format used, at which testimony and evidence may be presented. Briefing schedule follows.
  • Appeals from decisions may be taken to Commonwealth Court.

Glossary:

Average weekly wage (AWW). The number used to determine what loss of earnings benefits a worker who is injured on the job will receive under the Workers Compensation Act. There are various methods used to determine the average weekly wage, and the calculation process is complex.
 
Change of status petition (Petition To:). Multi-purpose checklist form that is used to change a workers compensation claimant's status or to review compensation documents and liability. The form can be used to file various petitions, including Petition to Terminate Compensation Benefits, Petition to Modify Compensation Benefits, and Petition to Suspend Compensation Benefits.
 
Claimant. The person who makes a claim or asserts a right; the injured worker who files a claim petition or otherwise receives workers compensation benefits.
 
Claim petition. When a worker is injured on the job, he or she files this type of petition to seek initial compensation after receiving a Notice of Workers Compensation Denial.
 
Compensation. Benefits received by injured employees for purposes of workers’ compensation, which include loss of earnings benefits for total disability or partial disability, specific loss benefits, death benefits and medical benefits.
 
Compensation rate. The amount of money an injured worker is entitled to receive per week for loss of earnings benefits.
 
Compromise and release (C&R). An agreement whereby a lump sum payment of money is paid by the insurance carrier to an injured worker to resolve the case. This lump sum is in lieu of the weekly compensation benefits the injured worker is receiving and may or may not include future medical benefits.
 
Contingent fee agreement. An agreement between an attorney and his or her client whereby the attorney agrees to represent the client for a percentage of the amount recovered.
 
Defendant. In a workers compensation case, the defendant is the employer, the insurance carrier, and, in certain cases, the Commonwealth of Pennsylvania.
 
Disability. For workers compensation purposes, it refers to the degree that a work-related injury affects an injured worker's earning power/wages.
 
Disfigurement. A technical term in workers compensation cases for a serious and permanent scar to the head, neck, or face.
 
Final receipt. In a workers compensation case, it's the form presented by the insurance carrier for the injured employee's signature so that benefits will stop upon return to work.
 
Independent Medical Examination (IME). Medical examination performed on an injured worker by a company doctor usually for the purpose of showing that a work-related injury no longer exists or that it has decreased in severity.
 
Notice of Compensation Payable (NCP). Acceptance of liability for a work-related injury filed by the employer or the employer's insurance carrier. Once a notice of compensation payable is filed, benefits would begin to be paid, and must begin to be paid, not later than 21 days after the employer receives notice of an employee's injury.
 
Notice of Temporary Compensation Payable (NTCP or TNCP). Temporary acceptance of liability for work-related injury filed by the employer or the employer's insurance carrier.
 
Notice of Workers Compensation Denial (NCD). Notice of denial of a work-related injury filed by the employer or the employer's insurance company. After a notice of workers compensation denial is filed, an injured employee has three years from the date of injury to file a claim petition.
 
Occupational disease (OD). A disease resulting from on-the-job exposure to conditions or substances detrimental to heath.
 
Partial disability. Any disability that is less than a total disability. Partial disability benefits are measured by comparing an injured worker's earnings before a work-related injury occurred with post-injury earnings.
 
Modification. Increase or reduction in the amount of workers compensation benefits payable because a disability either increases from partial to total or decreases from total to partial.
 
Suspension. Suspension of the claimant’s receipt of workers compensation benefits because there is no longer any disability or because of the claimant's failure to comply with certain requirements of the Workers Compensation Act.
 
Termination. Cessation of the claimant’s entitlement to workers’ compensation benefits, typically based upon the claimant’s full recovery from the work injury.
 
Reinstatement. Resumption of payment of workers compensation benefits after suspension or termination of benefits due to a recurrence of the disability which results in a loss of earning power.
 
Specific loss. The loss (amputation) or permanent loss of use of members of the body, the complete loss of hearing in one or both ears, and the loss of vision in one or both eyes.
 
State Workers’ Insurance Fund (SWIF). An issuer of workers’ compensation insurance created by the Workers’ Compensation Act; part of the Pennsylvania Department of Labor and Industry.
 
Supersedeas. The temporary staying or stopping of an obligation, in workers’ compensation matters this typically is relates to the insurer’s obligation to continue pay benefits to the claimant during litigation.
 
Supplemental agreement. An agreement between an injured worker and the employer or insurer entered into after a notice of compensation payable is issued or after an agreement for compensation has been signed which modifies, suspends, reinstates, or terminates the benefits then being received under the notice of compensation payable or under the original agreement between the parties.
 
Total disability. The total loss of earning power/wages as a result of the work injury.
 
Utilization Review Organization (URO). An organization authorized for the purpose of determining the reasonableness or necessity of medical treatment administered to workers with work-related injuries.
 
Workers Compensation Appeal Board (WCAB). An administrative board that exercises is powers and duties as an appeal board which reviews the legal decisions of workers compensation judges.
 
Workers compensation judge (WCJ). The hearing officer appointed to conduct hearings in an administrative proceeding for workers compensation cases.
 
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