Claims and Indemnity

Based upon the Statewide Average Weekly Wage, as determined by the Department of Labor & Industry for the fiscal year ending June 30, 2022, the maximum compensation payable under the Workers' Compensation Act, under Article 1, subsections 105.1 and 105.2, shall be $1,273.00 per week for injuries occurring on and after Jan. 1, 2023. For purposes of calculating the update to payments for medical treatment rendered on and after Jan. 1, 2023, the percentage increase in the Statewide Average Weekly Wage is 3 percent. Permanent total and partial disability is paid up to the same maximum. PPD is determined by the type of injury, age of the claimant, and other factors.

Claims are adjusted in-house by field investigators.

For more information regarding workers’ compensation claims and benefits available, visit the Bureau of Workers' Compensation.

All medical charges for treatment and equipment causally related to the injury are covered. A treating physician is chosen from a Panel of Physicians posted by the employer. Assuming the posting requirements are satisfied, the injured employee must treat with a panel physician for a period of 90 days following the initial visit. After that, the employee is usually free to treat with a physician of his/her choice.

Recent legislation established a medical fee schedule for workers' compensation treatment in Pennsylvania. This fee schedule reimburses health care providers at 113% of the prevailing Medicare rate.

SWIF has registered nurses on staff assigned to assist staff Medical Reviewers. Typically, they help evaluate the causal relationship of the injury to a questioned treatment or charge.