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What is a Statement of Wages?

The Statement of Wages (LIBC-494c) is the bureau form used by the employer to calculate an injured workers Average Weekly Wage (AWW) and corresponding Workers' Compensation Rate.  These calculations determine how much of a weekly or bi-weekly wage loss benefit you will be entitled to receive. If you have been employed for the past year, the employer will be obligated to take the wages from the highest three of the last four quarters to determine your AWW.  If you have not been an employee for the past year; if you have worked less than 13 weeks; or if you are a seasonal employee, the form also allows for the calculation of an AWW but uses different formulas.  Depending on your type of employment lodging and tips and gratuities may also factor into the calculation of your AWW.  You should receive your Statement of Wages when you receive your Notice of Compensation Payable, Temporary Notice of Compensation Payable, or Agreement for Compensation.

 

Free Workers' Compensation Case Evaluation

If you or a loved one have suffered a work injury and have questions about how much you may be entitled to receive – contact Norfleet and Lafferty to speak with our Pennsylvania workers’ compensation lawyers today.  Our Central Pennsylvania workers compensation attorneys in Harrisburg, York and Lemoyne will answer all of your questions and lead you through the complex workers’ compensation process.  Call (717) 737-7574 or fill out our case evaluation form.

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