What Is A Notice Of Compensation Payable?

• Dave Brown, Esquire
• 09/12/2024

If you injure yourself at work in Pennsylvania and cannot do your job, within a few weeks you should receive a document from the workers’ compensation insurance company for your employer informing you whether your claim has been accepted or denied. If it is denied, you will receive a document called a Notice of Workers’ Compensation Denial. If it is accepted, the insurance company will issue a document called a Notice of Compensation Payable but there are many variations of this document, depending on whether the acceptance is temporary and/or only covers part of your claim. We’ll describe the several Notices of Compensation Payable and how each affects your Pennsylvania workers’ comp. claim.

1. Notice of Compensation Payable (Wage Loss and Medical) – This is the document that you want to receive – it’s the best-case scenario for your claim. Your Pennsylvania workers’ comp. claim has been accepted for payment of wage loss benefits and payment of your medical bills. You will receive a weekly or bi-weekly check to compensate you for your lost wages, and your medical bills will be paid. While these payments will not be temporary, they won’t necessarily last indefinitely either. There are a number of things that can happen which will cause your wage loss and/or medical benefits to stop, which include: A Workers’ Compensation Judge could find that you have fully recovered from your work injury or you are capable of returning to work in either your time-of-injury job or a light-duty job; the insurance company files a utilization review, challenging the reasonableness and necessity of your medical treatment; or you settle your case, giving up your right to future wage loss and medical benefits. But at least if the insurance company issues a Notice of Compensation Payable, your benefits are not in any immediate jeopardy.
2. Notice of Temporary Compensation Payable (Wage Loss and Medical) – This is the same as a Notice of Compensation Payable with one important exception – the insurance company can change its mind within 90 days and issue a Notice Stopping Compensation Payable and a Notice of Workers’ Compensation Denial at which point your benefits, both wage loss and medical benefits, will cease. If 90 days pass and the insurance company does not take any action, the Notice of Temporary Compensation will automatically convert, and your wage loss and medical benefits will continue.
3. Notice of Compensation Payable (Medical Only) – The insurance company will sometimes issue a Medical-Only Notice of Compensation Payable in which it acknowledges that you sustained an injury but do not agree that the injury rendered you unable to do your job. So it will pay the bills for the medical treatment you receive for your injury but will not pay the more important component of your Pennsylvania workers’ compensation claim – money for your lost wages.
4. Notice of Temporary Compensation Payable (Medical Only) – This is the least desirable of the four Notices of Compensation Payable – only your medical bills will be paid, and there is a chance that within 90 days, the insurance company will have a change of heart and stop paying them.

In Scenarios 3 and 4, as well as Number 2 if the insurance company stops the Notice of Temporary Compensation Payable, you will need to hire a PA workers’ compensation lawyer to file a Claim Petition for you in order to receive wage loss benefits — and medical benefits if they are being denied too. The Workers’ Compensation Judge assigned to your case will hold a series of hearings, accept evidence in the form of depositions and documents, and issue a decision, either granting your Pennsylvania workers’ compensation claim, completely or partly, or denying your claim.
Another important point on the subject of Notices of Compensation Payable: Regardless of what type of Notice of Compensation Payable the insurance company issues, there will be a description of your injury contained in the document. Don’t be surprised if the description is incomplete or inaccurate. For example, you may injure your low back and knee in a work-related accident, but the insurance company only accepts your low back injury. Under these circumstances, the insurance company is denying that you injured your knee, and your lawyer will have to file a petition to get the knee injury added to your claim. The insurance company may also under-describe your injury in the Notice of Compensation Payable. In other words, you could sustain a tear to your rotator cuff, but the insurance company describes your injury as merely a shoulder sprain. This can become important because if your doctor recommends surgery for your rotator cuff tear, the insurance company likely will not agree to pay on the basis that your injury was limited to a shoulder sprain. This is another scenario in which a petition will have to be filed on your behalf to expand the description of your injury.

We have emphasized repeatedly that you may need to hire a lawyer to file a petition for you to protect your rights in your Pennsylvania workers’ comp. claim. It is important that you don’t hire just any PA workers’ comp lawyer – it’s paramount that you put your case in the capable hands of an experienced workers’ compensation lawyer. At Pearson Koutcher Law, we specialize in workers’ comp. law – all we do is represent injured workers in their workers’ comp. cases. We will know exactly what to do when the insurance company issues a Notice of Workers’ Compensation Denial or one of the Notices of Compensation Payable. If you have been injured, please call us for a free comprehensive evaluation of your case. One of our experienced and knowledgeable lawyers will answer all of your questions and represent you in your case.