Recent Changes in Pennsylvania Workers’ Compensation Laws

March 27, 2024
Stern & Cohen
Recent Changes in Pennsylvania Workers’ Compensation Laws - Construction Workers working on site

Workers’ compensation law is constantly changing to account for modern technology, new medical discoveries, and new workplace conditions. The following issues have been recently decided in Pennsylvania, changing how workers’ compensation law operates and is decided.  

1. Medical Marijuana Reimbursement 

Employers must pay for or pay back employees’ medical treatment costs resulting from a workplace injury in Pennsylvania. In 2016, the Medical Marijuana Act gave employers the option to pay for medical marijuana or not. However, it was unclear whether employers could pay back employees for their medical marijuana expenses related to work injuries. A court decided that even though the law doesn’t require employers to cover medical marijuana, they must pay back their employees for its expenses if they do decide to cover it. Fegley v. Firestone Tire & Rubber, 291 A.3d 940 (Pa. Cmwlth. 2023). 

2. Limiting Coverage for Consequential Injuries

If an employee gets hurt while working, their employer is responsible for any additional injuries resulting from the first injury. To get coverage for a following injury, in the past, the Court simply asked, “Would the second injury have happened if the first injury had not occurred?” But now, the Court may require more evidence to prove the injuries are related. In a recent case, the Court decided that a fall suffered by an employee after returning home from treatment for a workplace injury was not covered under workers’ compensation. This decision may make it harder for employees to get compensation for later injuries that happen because of their original workplace injury. Broomall v. Alpha Sintered Metals, LLC (Workers’ Comp. Appeal Bd.), 295 A.3d 743 (Pa. Commw. Ct. 2023) 

3. The Long-Utilized “Red Book” Standard Is Set Aside.

According to Pennsylvania’s Worker’s Compensation Act, most prescription drugs in workers’ compensation cases are paid for at a price that’s 110% of the Average Wholesale Price (AWP). To calculate this AWP, the Bureau of Workers’ Compensation has traditionally used a book called the “Red Book,” which shows the average prices of different medications. However, the prices of prescription drugs have been increasing rapidly, which has resulted in the AWP numbers in the Red Book being higher than what pharmacies actually charge. Recently, the Pennsylvania Commonwealth Court ruled that the Red Book’s AWP was not accurate and, as a result, invalid. This means that the Bureau of Workers’ Compensation needs to find a new way to determine prescription AWP. However, the Court did not provide any guidance on how to do this, so everyone is currently unsure how to figure out an AWP and calculate it. Federated Ins. Co. v. Summit Pharmacy (Bureau of Workers’ Comp. Fee Review Hearing Office), 2024 Pa. Commw. LEXIS 1 (Commw. Ct. Jan. 2, 2024). 

4. The Court Applies a Physical and Mental Standard to Full Disability Case.

Workers’ compensation is hard to obtain when one suffers from a mental health injury instead of, or more prominently than, a physical injury. Because of this, courts are hesitant to award damages when an employee is mainly affected psychologically by their injury. Recently, however, the Pennsylvania Commonwealth Court broke this tradition and awarded full disability to an employee with PTSD because of a workplace injury. The Court applied a physical/mental standard that requires an employee to show that their mental injury resulted from a triggering physical injury. The Court expanded on this standard, saying that the physical injury that causes the mental injury does not need to be severe; it only needs medical treatment. This decision paves the way for more mental health acknowledgment in workers’ compensation law. Sch. Dist. of Phila. v. Smith (Workers’ Comp. Appeal Bd.), 304 A.3d 58 (Pa. Commw. Ct. 2023).  

5. Representative Tim Brennan Offers up a New Bill That May Fix a Hole in the Pennsylvania Workers’ Compensation Act.

Currently, the Workers’ Compensation Act only provides relief to employees who experience disfigurement to the head, neck, or face. This relief cannot be provided for longer than 275 weeks (about 5 and a half years). Representative Brennan brought House Bill 930 to provide a broader range of relief to employees for a more extended period. If this bill is passed, employees who experience disfigurement on any part of their body will be eligible for benefits that can last up to 400 weeks (about 7 and a half years). Additionally, these benefits will no longer be tied to total or partial disability, allowing employees to receive both types of benefits if they qualify. The bill has passed the first committee and is now awaiting review from the Chamber of Representatives. 

Have you been injured at work?  Call Stern & Cohen at (215) 999-1443 or fill out a contact form below to get in contact with a Pennsylvania Workers’ Compensation Lawyer, today.