PA Workers Comp Calculator
Comparison · PA Workers' Comp 2026
Medical-Only vs. Lost-Time Claims — EMR Impact for PA Employers
Not all workers' comp claims are equal in the PCRB's experience modifier formula. A medical-only claim costs 70% less in the EMR calculation than an equivalent lost-time claim. Understanding this difference is the foundation of smart claims management strategy.
Medical Only vs. Lost Time — Feature Comparison
| Feature | Medical Only | Lost Time |
|---|---|---|
| EMR weighting | 30% of incurred cost | 100% of incurred cost |
| Example: $10,000 claim EMR impact | $3,000 counted | $10,000 counted |
| Example: $50,000 claim EMR impact | $15,000 counted | $50,000 counted |
| Wage replacement costs | None | Yes (2/3 AWW) |
| Typical duration | Days to weeks | Weeks to months (or more) |
| Requires return-to-work program | Less critical | Critical to limit duration |
Bottom Line
Converting a potential lost-time claim to medical-only — through prompt medical care, modified duty, and return-to-work programs — is the single most impactful claims strategy available. A $15,000 medical-only claim (counted as $4,500 in the EMR) vs. the same claim going lost-time at $40,000+ (counted as $40,000+) is a $35,500 difference in EMR exposure — and the EMR impact compounds for 3 years.
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Frequently Asked Questions
How do I keep a claim medical-only in Pennsylvania?
The keys are: (1) Respond immediately to injuries with on-site first aid, (2) Direct the injured worker to an occupational health provider — not the ER — for evaluation, (3) Have a panel physician ready to see workers same-day, (4) Offer modified duty within the worker's restrictions as soon as medically cleared, (5) Maintain daily contact with the injured worker and their supervisor.
Does a medical-only claim affect workers' comp rates in Pennsylvania?
Yes, but at a reduced weight. Medical-only claims count at 30% of their incurred cost in the PCRB EMR formula. So a $5,000 medical-only claim contributes $1,500 to the EMR calculation, compared to $5,000 for the same claim going lost-time. The reduction incentivizes employers to keep injured workers at work.
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