Glossary · PA Workers' Comp

Medical-Only Claim

A workers' comp claim in which the injured worker requires medical treatment but misses fewer than 8 days of work, incurring no wage replacement costs.

Definition

A medical-only claim is a workers' compensation claim where the injured employee requires medical treatment but does not miss enough work to qualify for wage replacement benefits — typically fewer than 8 days of lost time.

Medical-Only Claims and the EMR Discount: Why Prompt Treatment Matters

Medical-only claims have a significantly lower impact on the experience modifier than lost-time claims. In the EMR calculation, medical-only claims are typically weighted at only 30% of their actual cost. This incentivizes employers to provide prompt medical treatment while encouraging return-to-work.

Promptly reporting all injuries — even minor ones — and facilitating immediate medical care is key to keeping claims in the medical-only category. A delayed report can allow a minor injury to progress to a lost-time claim.

Establishing a relationship with an occupational health clinic that understands workers' comp return-to-work requirements is essential for managing medical-only claims effectively.