How Employers Limit Benefits

August 8, 2019

There are many ways in which employers limit benefits when it comes to workers’ compensation. They may deny a worker’s claim outright or seek to reduce the benefits that a worker is already receiving. However, Pennsylvania employers may not suspend, modify, or terminate a worker’s benefits without adhering to certain procedures and meeting the legal requirements. If your employer is attempting to limit your benefits, a Philadelphia workers’ compensation lawyer at Larry Pitt & Associates, P.C. can help ensure that your rights are protected and that you continue receiving the benefits to which you are entitled.

Diminished Earning Capacity

The amount of benefits a worker will receive depends, in part, upon the worker’s diminished earning capacity – the extent to which a worker’s ability to earn the wages he or she did prior to the injury is lessened. To prove diminished earning capacity, a worker must show that his or her injury is permanent, meaning that it is constant and visible or that it will continue to produce persistent symptoms. Additionally, the injury must affect the worker’s employability. Therefore, even if an injury is permanent, it will not be compensable under diminished earning capacity unless it adversely impacts the worker’s ability to secure future employment.

Determining Factors

Pennsylvania courts have established several factors that must be considered in lost future earning capacity cases. In addition to the worker’s medical condition, courts may also consider the worker’s:

  • Age
  • Education
  • Estimated length of recovery time
  • Estimated wages before the injury
  • Injuries and whether they permanent
  • Occupation/nature of the job
  • Pre-existing injuries
  • Work experience

Labor Market Surveys

Employers’ insurance companies often try to limit workers’ benefits by subjecting them to labor market surveys. Those seeking to limit or terminate a worker’s benefits must first hire a vocational expert to conduct a survey of the available jobs in the area that he or she believes the worker could fill given the worker’s background, skills, experience, and medical limitations. The expert must conduct an interview with the worker to assess whether the worker possesses transferrable skills and other employability factors.

The expert’s earning power assessment shall provide an estimate of how much a worker should be able to make based on the expert’s evaluation of the labor market. In Pennsylvania, a worker need not actually secure work to validate the earning power assessment; it is enough for the vocational expert to merely show that there are available jobs that the worker could potentially fill.

Suspending, Modifying, or Terminating Benefits

Employers may not suspend, modify, or terminate a worker’s benefits without first proving that the worker’s medical status has changed and he or she is able to return to work, in whatever capacity possible. Before changing the payments, employers must send the worker for an Independent Medical Examination (IME), earning capacity assessment, and labor market survey.

Philadelphia Workers’ Compensation Attorneys at Larry Pitt & Associates, P.C. Fight for Your Right to Compensation

If your employer is seeking to limit your benefits, contact a Philadelphia workers’ compensation attorney at Larry Pitt & Associates, P.C. Our experienced attorneys can help ensure that your rights are protected and that you receive all the benefits to which you are entitled. Contact us online or call 888-PITT-LAW today to arrange a free consultation.

We serve clients throughout Pennsylvania from our offices in PhiladelphiaBensalemLansdowne, and Reading, including those in the areas of Berks CountyBucks CountyChester CountyDelaware CountyMontgomery CountyPhiladelphia County, and the communities of AbingtonAmblerArdmoreBala CynwydBensalemClifton HeightsCrum LynneDarbyDowningtownDoylestownDrexel HillEssingtonFolcroftGlenoldenHaverfordHavertownHolmesKutztownLansdowneMediaMerion StationMortonNarberthNorristownNorwoodPhiladelphiaProspect ParkQuakertownReadingRoxboroughSharon HillUpper DarbyWest Chester, and Wynnewood.