Recent Changes in Pennsylvania Workers’ Compensation Laws
Pennsylvania workers’ compensation laws continue to evolve through new court decisions and legislation. Recent changes have addressed issues such as medical marijuana reimbursement, mental health claims, coverage for consequential injuries, prescription drug costs, and proposed expansions to disfigurement benefits for injured workers.
Pennsylvania Workers’ Compensation Law Continues to Evolve
Workers’ compensation law is constantly changing to account for new workplace conditions, medical advancements, and court interpretations of the Pennsylvania Workers’ Compensation Act.
Recent court decisions and legislative proposals have impacted how workers’ compensation claims are evaluated and what benefits may be available to injured workers. Below are several important developments that may affect Pennsylvania workers’ compensation cases.
Medical Marijuana Reimbursement in Pennsylvania Workers’ Compensation Cases
Employers and workers’ compensation insurance carriers are generally responsible for paying reasonable and necessary medical treatment related to a work injury.
Following the passage of Pennsylvania’s Medical Marijuana Act, questions arose regarding whether injured workers could be reimbursed for medical marijuana expenses related to a work injury.
In Fegley v. Firestone Tire & Rubber, the Pennsylvania Commonwealth Court addressed this issue. The court determined that employers may be required to reimburse injured workers for medical marijuana expenses related to a compensable work injury under certain circumstances.
This decision continues to impact how medical marijuana reimbursement issues are handled in Pennsylvania workers’ compensation claims.
Consequential Injuries and Workers’ Compensation Coverage
Pennsylvania workers’ compensation benefits may extend beyond an initial workplace injury.
Historically, if an injured worker suffered a secondary injury that resulted from the original work injury, the subsequent injury could also be covered.
However, recent court decisions suggest that injured workers may need stronger evidence connecting the secondary injury to the original workplace accident.
In Broomall v. Alpha Sintered Metals, LLC, the court found that an employee’s fall after returning home from treatment was not sufficiently connected to the original work injury to qualify for benefits.
As a result, proving consequential injuries may require more detailed medical evidence than in the past.
Prescription Drug Reimbursement and the “Red Book” Decision
Pennsylvania workers’ compensation law generally requires prescription medications to be reimbursed at 110% of the Average Wholesale Price (AWP).
For years, the Bureau of Workers’ Compensation relied on a publication known as the “Red Book” to determine AWP.
In Federated Insurance Co. v. Summit Pharmacy, the Pennsylvania Commonwealth Court concluded that the Red Book’s pricing methodology was no longer a reliable measure of actual prescription drug costs.
The court’s decision invalidated the longstanding use of the Red Book for workers’ compensation prescription reimbursement calculations and created uncertainty regarding how future AWP calculations should be determined.
This issue continues to affect workers’ compensation insurers, pharmacies, and injured workers throughout Pennsylvania.
PTSD and Mental Health Claims After a Workplace Injury
Mental health injuries have historically been among the most difficult workers’ compensation claims to prove.
In a significant decision, the Pennsylvania Commonwealth Court recognized full disability benefits for an injured worker suffering from PTSD that developed following a work-related physical injury.
In School District of Philadelphia v. Smith, the court applied Pennsylvania’s physical-mental injury standard and clarified that the physical injury triggering the psychological condition does not need to be severe. Instead, the physical injury must simply be sufficient to require medical treatment.
This decision may help injured workers pursue benefits when psychological injuries such as PTSD arise from workplace accidents.
Proposed Changes to Pennsylvania Disfigurement Benefits
Pennsylvania currently provides workers’ compensation disfigurement benefits for serious and permanent scars or disfigurement involving the head, face, or neck.
Representative Tim Brennan introduced House Bill 930, which proposes significant changes to these benefits.
If enacted, the legislation would:
- Expand disfigurement benefits to injuries involving any part of the body
- Increase the maximum duration of benefits from 275 weeks to 400 weeks
- Allow disfigurement benefits to be received in addition to other disability benefits in certain circumstances
While the proposal has advanced through committee review, it has not become law.
If passed, the legislation would significantly expand available benefits for workers who suffer permanent scarring and disfigurement due to workplace injuries.
Why These Developments Matter for Injured Workers
Workers’ compensation laws do not remain static.
Court decisions and legislative changes can affect:
- Medical treatment rights
- Wage-loss benefits
- Mental health claims
- Prescription medication coverage
- Disfigurement awards
- Future settlement value
Because the law continues to evolve, injured workers should stay informed about developments that may affect their rights and benefits.
Talk to a Pennsylvania Workers’ Compensation Lawyer
If you have been injured at work, Stern & Cohen can help.
Our Pennsylvania workers’ compensation attorneys stay current on changes in the law and fight to protect the rights of injured workers throughout Pennsylvania.
Contact Stern & Cohen today for a free consultation.
FAQs
Does Pennsylvania workers' compensation cover medical marijuana?
Potentially. Pennsylvania courts have recognized that injured workers may be entitled to reimbursement for medical marijuana expenses related to a compensable work injury under certain circumstances.
Can I receive workers' compensation benefits for PTSD in Pennsylvania?
Yes. PTSD and other psychological injuries may be compensable when they are connected to a work-related physical injury and supported by medical evidence.
Are mental health conditions covered by workers' compensation?
Potentially. Pennsylvania workers’ compensation may cover certain mental health conditions, including PTSD, anxiety, and depression, depending on the circumstances of the case.
What is a consequential injury in a workers' compensation claim?
A consequential injury is an injury that develops as a result of an original work-related injury. Coverage often depends on whether medical evidence establishes a connection between the two injuries.