How to Get Paid from Workers’ Compensation in Pennsylvania

Getting paid from workers’ compensation in Pennsylvania requires following a specific sequence of steps — and missing any one of them can delay benefits, reduce the amount you receive, or eliminate your claim entirely. The system is a no-fault benefit program, meaning you do not have to prove your employer did anything wrong. You just have to prove the injury happened at work and follow the correct process. The problem is that the process has traps at nearly every stage, and the insurance company knows where all of them are.

At Lerner, Steinberg and Associates, we have guided injured Pennsylvania workers through this process for more than 34 years. Here is a clear, step-by-step breakdown of how to get paid from workers’ compensation in Pennsylvania, what benefits you are entitled to, and what happens when the insurance company tries to cut them off.

Step 1: Report the Injury to Your Employer Immediately

The first step — and the one with the hardest deadlines — is reporting the injury to your employer. Pennsylvania law sets three critical reporting windows:

• Within 21 days — report the injury and your benefits are retroactive to the date of injury
• Between 21 and 120 days — you can still report and receive benefits, but only from the date you reported, not from the date of the injury
• After 120 days — the claim may be barred entirely, regardless of how serious the injury is

Report in writing whenever possible. Telling a supervisor verbally satisfies the legal requirement, but a written report creates a record the insurance company cannot later claim it never received. For injuries that develop gradually — carpal tunnel syndrome, repetitive stress injuries, occupational diseases — the clock starts from the date you knew or should have known the condition was work-related.

Step 2: Get Medical Treatment and Document It Correctly

Medical documentation is the foundation of your workers’ compensation claim. From day one, every treating provider must know and record in the medical chart that your injury is work-related. Insurance companies look for any medical record that does not explicitly connect the condition to work, and they use those records to argue the injury is unrelated to employment.

Pennsylvania has a panel provider rule for the first 90 days after injury. If your employer posted a valid list of at least six designated healthcare providers and gave you written notice of the list at the time of hire or at the time of injury, you must treat with a provider on that list for the first 90 days. After 90 days, you may choose your own physician. We cover the specific rules around this in our guide on seeing your own doctor for a workers’ comp claim.

If your employer did not post a valid panel list or did not provide proper written notice, you may see your own doctor from day one.

Step 3: Your Employer Files the First Report of Injury

Once you report the injury, your employer is legally required to file a First Report of Injury with the Pennsylvania Bureau of Workers’ Compensation within 48 hours for injuries requiring more than a day off work. The insurance company then has 21 days from the date of the employer’s notice to accept or deny the claim.

If the insurance company accepts the claim, they issue a Notice of Compensation Payable and your weekly benefit checks begin. If they deny the claim, they issue a Notice of Workers’ Compensation Denial. A denial is not the end of the road — it is the start of the formal dispute process.

Step 4: Understand What Benefits You Are Entitled To

Pennsylvania workers’ compensation covers four main categories of benefits:

Wage loss benefits — paid weekly when you are unable to work or earn less than your pre-injury wage. The amount is calculated using a four-tier schedule based on your Average Weekly Wage. According to the Pennsylvania Department of Labor and Industry, the Statewide Average Weekly Wage for 2026 is $1,394, which is the maximum weekly benefit. The four tiers are:

• AWW of $2,091.01 or more — flat $1,394/week
• AWW between $1,045.51 and $2,091.00 — two-thirds of AWW
• AWW between $774.44 and $1,045.50 — flat $697/week
• AWW of $774.43 or less — 90% of AWW

Medical benefits — all reasonable and necessary medical treatment for the work injury is covered with no co-pays and no deductibles. This includes emergency care, surgery, physical therapy, prescriptions, diagnostic imaging, and durable medical equipment.

Specific loss benefits — fixed payments for permanent loss or loss of use of specific body parts, paid on a statutory schedule regardless of whether you return to work.

Disfigurement benefits — up to 275 weeks of benefits for serious permanent disfigurement of the head, face, or neck.

Step 5: The Insurance Company Accepts, Modifies, or Denies

Within 21 days of notice, the insurance company must take one of three actions:

• Issue a Notice of Compensation Payable (NCP) — accepting the claim and commencing benefits
• Issue a Notice of Temporary Compensation Payable (TNCP) — paying benefits temporarily for up to 90 days while investigating, without admitting liability
• Issue a Notice of Workers’ Compensation Denial — denying the claim, which triggers your right to file a Claim Petition

If the insurer pays under a TNCP for 90 days without converting to a full NCP, the claim is deemed accepted. If they deny, you file a Claim Petition with the Bureau of Workers’ Compensation and your case goes before a Workers’ Compensation Judge. We cover what happens in that process in our overview of denied workers’ compensation claims in Pennsylvania.

Step 6: How Weekly Benefits Are Actually Paid

Once benefits are accepted, the insurance carrier pays your weekly compensation directly — typically by check or direct deposit. Payments begin within 10 days of the employer’s notice of injury for accepted claims. Benefits continue as long as you remain disabled and the insurance company has not successfully petitioned to modify or terminate them.

Payments cover both total and partial disability:

• Total disability — you receive your full weekly compensation rate when you cannot work at all
• Partial disability — if you return to work at reduced hours or lower pay, you receive two-thirds of the difference between your pre-injury AWW and your current earnings, for up to 500 weeks

Step 7: What Happens at the 104-Week Mark

After 104 weeks of total disability benefits, the insurance company has the right to request an Impairment Rating Evaluation performed by a physician using American Medical Association guidelines. If the rating comes back below 35 percent whole-body impairment, your benefits automatically convert from total disability to partial disability — which is capped at 500 additional weeks. If the rating is 35 percent or above, you remain on total disability benefits.

The IRE is one of the insurance company’s most powerful tools. Contesting an unfavorable IRE requires prompt legal action and often a rebuttal evaluation from your own physician.

When to Get an Attorney Involved

Workers’ compensation in Pennsylvania is technically a no-attorney-required system. In practice, injured workers without attorneys consistently receive lower benefits, have more claims denied, and settle for less than the value of their cases. The insurance company has a full-time defense attorney working your claim. Having your own representation levels the playing field.

We explain the specific circumstances where having an attorney makes the biggest difference in our guide on when to hire a workers’ compensation lawyer in Pennsylvania.

How Lerner, Steinberg and Associates Can Help

Getting paid what you are owed from workers’ compensation requires navigating claim filings, medical panel requirements, benefit calculations, IRE challenges, and insurance company petitions — often simultaneously. We have done this across Pennsylvania for more than 34 years. If your claim has been denied, your benefits have been cut, or you are not sure whether you are receiving the correct amount, schedule a free consultation through our contact page. We will review your claim, identify any gaps, and tell you exactly where you stand.

Frequently Asked Questions About Getting Paid from Workers’ Comp in Pennsylvania