Workers Comp Primary Insurance Amount (PIA) Benefits

Last Updat­ed on May 31, 2023 

In work­ers’ com­pen­sa­tion, Pri­ma­ry Insur­ance Amount (PIA) is the max­i­mum amount of mon­ey that an injured work­er can receive in ben­e­fits each week. The PIA is based on the work­er’s aver­age week­ly wage and their age at the time of the injury.

What is PIA Calculator?

The PIA is cal­cu­lat­ed using a for­mu­la that is set by each state. The for­mu­la typ­i­cal­ly takes into account the work­er’s aver­age week­ly wage, their age at the time of the injury, and the state’s max­i­mum week­ly ben­e­fit amount.

For exam­ple, in Cal­i­for­nia, the PIA for­mu­la is as follows:

PIA = (AWW x 0.9) x (58 + (A - 58) x 0.05)

Where:

• AWW = Aver­age week­ly wage
• A = Work­er’s age at the time of the injury

The max­i­mum week­ly ben­e­fit amount in Cal­i­for­nia is $1,170.

So, for exam­ple, a work­er who is 40 years old and has an aver­age week­ly wage of $500 would have a PIA of $625.

PIA Applications

The PIA is used to cal­cu­late the amount of tem­po­rary dis­abil­i­ty ben­e­fits, per­ma­nent dis­abil­i­ty ben­e­fits, and death ben­e­fits that an injured work­er can receive.

PIA Temporary Benefits

Tem­po­rary dis­abil­i­ty ben­e­fits are paid to work­ers who are unable to work due to a work-relat­ed injury. The amount of tem­po­rary dis­abil­i­ty ben­e­fits that a work­er receives is based on their PIA.

PIA Permanent Benefits 

Per­ma­nent dis­abil­i­ty ben­e­fits are paid to work­ers who have suf­fered a per­ma­nent injury that reduces their earn­ing capac­i­ty. The amount of per­ma­nent dis­abil­i­ty ben­e­fits that a work­er receives is based on their PIA and the sever­i­ty of their injury.

PIA Death Benefits 

Death ben­e­fits are paid to the depen­dents of a work­er who has died as a result of a work-relat­ed injury. The amount of death ben­e­fits that a work­er’s depen­dents receive is based on the work­er’s PIA.

PIA Application Process

The process of apply­ing for PIA ben­e­fits varies from state to state, but it typ­i­cal­ly includes the fol­low­ing steps:

1. Report the injury to your employ­er as soon as possible.
2. Obtain med­ical treat­ment for the injury.
3. File a work­ers’ com­pen­sa­tion claim with your employ­er’s insur­ance company.
4. Attend a med­ical eval­u­a­tion to deter­mine the extent of your injury.
5. Sub­mit a request for PIA ben­e­fits to the work­ers’ com­pen­sa­tion insur­ance company.

The work­ers’ com­pen­sa­tion insur­ance com­pa­ny will review your request and make a deci­sion on whether or not to approve your ben­e­fits. If your ben­e­fits are approved, you will begin receiv­ing pay­ments on a month­ly basis.

If you are denied ben­e­fits, you may be able to appeal the deci­sion. You should con­tact an attor­ney who spe­cial­izes in work­ers’ com­pen­sa­tion law if you need help appeal­ing a denial of benefits.

Here are some additional tips for applying for PIA benefits:

• Keep good records of your injury, includ­ing med­ical records, acci­dent reports, and any oth­er doc­u­men­ta­tion relat­ed to your injury.
• Be sure to fol­low all of the instruc­tions from your employ­er and the work­ers’ com­pen­sa­tion insur­ance company.
• Be patient. The process of apply­ing for PIA ben­e­fits can take sev­er­al months.

If you have been injured on the job, you should con­tact your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny to file a claim. You may be eli­gi­ble for PIA benefits.