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Glossary · PA Workers' Comp
Lost-Time Claim
A workers' comp claim where the injured worker misses more than 7 days of work and becomes eligible for wage replacement benefits — the most EMR-impactful claim type.
Definition
A lost-time claim is a workers' compensation claim where the injured employee is disabled from work for more than 7 days and becomes entitled to wage replacement (indemnity) benefits. Lost-time claims are the most significant type for EMR purposes.
Why Lost-Time Claims Drive EMR Increases and How to Contain Them
Lost-time claims are weighted at 100% (full value) in the experience modifier calculation, compared to 30% for medical-only claims. A single serious lost-time claim can raise an employer's EMR significantly.
The most effective strategy for managing lost-time claims is prevention first, then — when injuries do occur — aggressive return-to-work with modified duty to limit the duration of wage replacement.
Pennsylvania law requires that wage replacement begins for lost time after a 7-day waiting period. If disability lasts more than 14 days, the waiting period is paid retroactively.
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