PROPOSED RULEMAKING
DEPARTMENT OF LABOR AND INDUSTRY
[34 PA. CODE CH. 121]
General Provisions
[35 Pa.B. 3807] The Department of Labor and Industry (Department), Bureau of Workers' Compensation (Bureau), proposes to amend Chapter 121 (relating to general provisions) to read as set forth in Annex A. The proposed rulemaking updates and clarifies the existing regulations that govern the Bureau's administration of the Workers' Compensation Act (act) (77 P. S. §§ 1--1041.4 and 2501--2506) and the procedures utilized by employees, employers and insurers.
Statutory Authority
This rulemaking is proposed under the authority in sections 401.1 and 435(a) of the act (77 P. S. §§ 710 and 991(a)) and section 2205 of The Administrative Code of 1929 (71 P. S. § 565).
Background
Chapter 121 was adopted on March 15, 1974, and has not been revised recently, with a few exceptions. The most recent regulatory amendments followed the act of November 26, 1997 (P. L. 530, No. 57), which amended sections 306.2, 443 and 446 of the act (77 P. S. §§ 517, 999 and 1000.2). The Department then amended §§ 121.1, 121.22 and 121.23 (relating to general; subsequent injury fund; and supersedeas fund). Further, the Department added §§ 121.31--121.35.
On June 11, 2004, a stakeholder meeting was held. Written comments were also received from the following groups: The Insurance Federation of Pennsylvania, Inc. (submitted by Samuel R. Marshall, President and CEO); the Pennsylvania Trial Lawyers Association (submitted by Richard J. Schubert, Esquire, President); and the Workers' Compensation Office of Adjudication (submitted by David Cicola, Director). Actual attendees at the June 11, 2004, meeting were Lawrence Chaban on behalf of the Pennsylvania Trial Lawyers Association and Samuel R. Marshall on behalf of The Insurance Federation of Pennsylvania, Inc. All comments and suggestions have been reviewed and considered.
Purpose
The proposed rulemaking updates and clarifies the practices of the Bureau in the administration of the act and of employees, employers, workers' compensation insurers and other interested parties in their transactions with the Bureau.
Summary of Proposed Regulations
The Department proposes to amend § 121.1 to include definitions of ''agreement,'' ''Board,'' ''claimant,'' ''Disease Law'' and ''employer.''
The Department proposes to delete § 121.2 (relating to superseded provisions) because it is unnecessary.
The Department proposes to amend § 121.3 (relating to completion of forms) to better reflect the requirements of filing forms. Also, the Department proposes to add subsection (c) to clarify the Bureau's ability to require electronic filing and subsection (d) to clarify how to determine a filing date.
The Department proposes to add § 121.3a (relating to computation of time) to explain how a period of time will be computed under Chapter 121.
The Department proposes to add § 121.3b (relating to posting workers' compensation information) to require the posting of general workers' compensation information at an employer's primary places of business and all employment sites. This new mandatory posting is proposed to provide the opportunity to employees to learn basic workers' compensation information that otherwise may be difficult to obtain.
The Department proposes to delete § 121.4 (relating to reproduction of forms) because it currently contains information that is duplicated in § 121.3(a).
The Department proposes to amend § 121.5 (relating to reporting injuries) to correct the requirements regarding filing an Employer's Report of Occupational Injury or Disease, Form LIBC-344. The proposed amendment eliminates language in subsections (b) and (e) regarding disability continuing more than or beyond the entire day, shift or turn. The language in new subsection (c) conforms to section 438 of the act (77 P. S. § 994). Also, the Department proposes to delete unnecessary language discussing variances and to clarify existing language.
The Department proposes to delete § 121.6 (relating to supplemental reports) because the process currently described in this section is obsolete.
The Department proposes to amend § 121.7 (relating to notice of compensation payable) to add requirements for filing a Notice of Temporary Compensation Payable, Form LIBC-501. Also, the Department proposes to amend § 121.7 to require filing of a Statement of Wages, Form LIBC-494A or LIBC-494C, with every Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501. The Department also proposes to delete language in subsection (b) regarding injuries. To conform to section 406.1 of the act (77 P. S. § 717.1), proposed subsection (a) references ''disability.'' The Department also proposes to allow an employer to file an estimated or amended Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501. Finally, the Department proposes to add subsection (f) to allow an employer to file a Notice of Compensation Payable, Form LIBC-495, in medical only cases.
The Department proposes to amend § 121.8 (relating to agreements) to require the filing of a Statement of Wages, Form LIBC-494A or LIBC-494C, with every Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336. The Department also proposes to allow an employer to file an estimated or amended Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336.
The Department proposes to amend § 121.9 (relating to agreements-fatal cases) to clarify that death must occur from the injury, not within 7 days of the injury, to be compensable. Also, the Department proposes to amend § 121.9 to require the filing of a Statement of Wages, Form LIBC-494A or LIBC-494C, with every Agreementfor Compensation for Death, Form LIBC-338. The Department also proposes to allow an employer to file an estimated or amended Agreement for Compensation for Death, Form LIBC-338.
The Department proposes to delete § 121.10 (relating to supplemental agreements) because supplemental agreements are discussed in proposed § 121.17(b) (relating to termination).
The Department proposes to amend § 121.11 (relating to supplemental agreements--fatal) to clarify the circumstances on which a change of compensation may be based.
The Department proposes to amend § 121.12 (relating to Department review of agreements, and notices of compensation payable) to require an amended version of an agreement, Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, when a correction of errors results in an increase of an employee's wage or compensation. Additionally, the Department proposes to amend § 121.12 to require the filing of a Statement of Wages, Form LIBC-494A or LIBC-494C, with every amended form under this section.
The Department proposes to amend §§ 121.13 and 121.14 (relating to denial of compensation; and weekly wage, occupational disease cases) to clarify existing language.
The Department proposes to amend § 121.15 (relating to compensation payable) to clarify that death must occur from the injury, not within 7 days of the injury, to be compensable.
The Department proposes to amend § 121.16 (relating to statement of compensation paid) to eliminate the requirement of filing an annual Statement of Account of Compensation Paid, Form LIBC-392. The Department proposes, instead, to require the filing of an Annual Claims Status Report, Form LIBC-774, on which an insurer will verify information on its claims. Additionally, the Department proposes to amend § 121.16 to require the filing of a Final Statement of Account of Compensation Paid, Form LIBC-392, immediately after the final payment of compensation.
The Department proposes to amend § 121.17 to explain the procedures for obtaining changes in compensation, including termination, suspension, modification and other changes.
The Department proposes to amend § 121.18 (relating to subrogation procedure) to clarify existing language.
The Department proposes to amend § 121.20 (relating to commutation of compensation) to clarify existing language and to change the reference from a ''25-week period'' to a ''52-week period.''
The Department proposes to amend § 121.21 (relating to coal diseases--claim and reimbursement) to require record retention for 3 years, instead of indefinitely. The Department also proposes to amend § 121.21 to clarify existing language.
The Department proposes to amend §§ 121.22 and 121.23 to clarify existing language.
The Department proposes to delete § 121.24 (relating to approval of fees). The existing requirements concerning attorney fees have been more appropriately addressed in Chapter 131 (relating to special rules of administrative practice and procedure before workers' compensation judges).
The Department proposes to amend § 121.25 (relating to delivery of compensation checks) to allow delivery of a claimant's compensation check to the claimant's attorney if the claimant and employer have executed an Authorization for Alternative Delivery of Compensation Payments, Form LIBC-10, or if a court orders delivery.
The Department proposes to delete § 121.26 (relating to required information for maximum compensation rate increase) because it currently contains language that is duplicative to other language in these regulations.
The Department proposes to amend § 121.27 (relating to violations of the provisions of the act or this chapter) to clarify the process involved with an order to show cause. Additionally, the Department proposes to amend § 121.27 to eliminate language regarding penalty petitions, which will be placed in § 121.27a (relating to Bureau intervention and penalties).
The Department proposes to add § 121.27a to address the Bureau's involvement in penalty petitions.
The Department proposes to delete § 121.28 (relating to petitions designated as a request for supersedeas) because supersedeas requests have been more appropriately addressed in Chapter 131.
The Department proposes to amend § 121.30 (relating to still payable list) to require record retention for 3 years, instead of indefinitely. Additionally, the Department proposes to amend § 121.30 to add language regarding the Bureau's ability to make payments within its discretion to a claimant where the employer has failed to make payments. The Department also proposes to amend § 121.30 to clarify existing language.
The Department proposes to amend §§ 121.31--121.35 to clarify existing language.
Affected Persons
The persons affected by this proposed rulemaking are employees, employers and workers' compensation insurers.
Fiscal Impact
There is no significant fiscal impact associated with this proposed rulemaking.
Reporting, Recordkeeping and Paperwork Requirements
This proposed rulemaking requires the creation of only one new form, the Annual Claims Status Report, Form LIBC-774, and one new posting. However, the annual filing of a Statement of Account of Compensation Paid, Form LIBC-392, has been eliminated. Existing forms require few modifications. Therefore, this proposed rulemaking does not impose any significant additional reporting, recording or paperwork requirements on either the Commonwealth or the regulated community.
Effective Date
This proposed rulemaking will take effect upon final-form publication in the Pennsylvania Bulletin.
Sunset Date
A sunset date is not appropriate for these regulations. However, the Department will continue to monitor the impact and effectiveness of the regulations.
Contact Person
Interested persons should submit written comments to the proposed rulemaking to John Kupchinsky, BureauDirector, Bureau of Workers' Compensation, Department of Labor and Industry, Chapter 121 Regulations-Comments, P. O. Box 15121, Harrisburg, PA 17105, jkupchinsk@state.pa.us. Written comments must be received within 30 days of the publication of this proposed rulemaking in the Pennsylvania Bulletin. Written comments received by the Department may be made available to the public.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on June 27, 2005, the Department submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Committee on Labor and Industry and the House Labor Relations Committee. A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Department, the General Assembly and the Governor of comments, recommendations or objections raised.
STEPHEN M. SCHMERIN,
SecretaryFiscal Note: 12-67. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 34. LABOR AND INDUSTRY
PART VIII. BUREAU OF WORKERS' COMPENSATION
CHAPTER 121. GENERAL PROVISIONS § 121.1. [General] Definitions.
[(a) Purpose. This chapter has been promulgated in response to the legislative mandate in the act and designed to further the lawful, efficient and speedy administration of the act. The term ''employer'' as used in this chapter means, when applicable, the insurer thereof and a self-insured employer.
(b) Definitions.] The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Act--The [Pennsylvania] Workers' Compensation Act (77 P. S. §§ [1--2626] 1--1041.4 and 2501--2506).
Agreement--For purposes of this chapter, an agreement is limited to any of the following:
(i) Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336.
(ii) Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337.
(iii) Agreement for Compensation for Death, Form LIBC-338.
(iv) Supplemental Agreement for Compensation for Death, Form LIBC-339.
Approved rating organization--One or more organizations situated within this Commonwealth, subject to supervision and to examination by the Insurance Commissioner and approved by the Insurance Commissioner as adequately equipped to perform the functions specified in [Chapter 7B] Article VII of the act (77 P. S. §§ 1035.1--1035.22)[,] on an equitable and impartial basis.
Board--The Workers' Compensation Appeal Board.
Bureau--The Bureau of Workers' Compensation of the Department.
Claimant--An individual who files a petition for, or otherwise receives, benefits under the act or the Disease Law.
Department--The Department of Labor and Industry of the Commonwealth.
Disease Law--The Pennsylvania Occupational Disease Act (77 P. S. §§ 1201--1603).
Earned premium--A direct premium earned as required to be reported to the Insurance Department on Special Schedule ''W,'' under section 655 of The Insurance Company Law of 1921 (40 P. S. § 815). For the purposes of this chapter, direct premium earned may not include:
* * * * * (ii) Premiums not attributable to coverage under the act or [The Pennsylvania Occupational Disease Act (77 P. S. §§ 1201--1603)] the Disease Law.
* * * * * Employer--As defined in sections 103 and 401 of the act (77 P. S. §§ 21 and 701), including the insurer and a self-insured employer.
* * * * * Insured employer--An employer which has chosen to insure its workers' compensation liabilities through a [workers] workers' compensation insurance carrier licensed to do so in this Commonwealth. [The term ''employer'' when used in this context does not include the insurer thereof.]
* * * * * Runoff self-insurer--An employer that had been a self-insurer but no longer maintains a current permit to self-insure under section 305 of the act.
* * * * * § 121.2. [Superseded provisions] (Reserved).
[Each and every provision promulgated by this Bureau of Workers' Compensation, effective before the date of adoption of this chapter, is superseded as of the effective date of this chapter.]
§ 121.3. [Completion of forms] Filing of forms.
[In most instances, every filing in the claim and petition process shall be on a Departmental form identified with an OIDC designation. Each question or space on every form shall be completed to the best of the party's knowledge. If there is a reason why a question or space cannot be completed, then that reason shall be stated in the space; that is not applicable (n/a), zero, none, and the like. Forms not properly completed will be returned. Distribution of forms shall be in accordance with instructions on the forms.]
(a) Forms must be in the format prescribed by the Bureau. All references to forms shall mean paper forms or an electronic format prescribed by the Bureau.
(b) The Bureau may return forms that are not properly completed or filed. The Bureau will notify a party if a form is returned. For a form returned for the first time, the Bureau will preserve the filing date if the submitting party files a corrected version of the form within 10 days of the written notice of the return of the form.
(c) The Bureau may require the filing of forms or data through electronic means.
(d) The filing date is the date indicated on the United States Postal Service postmark or postal receipt. If the postmark or postal receipt is absent or unreadable, the filing date is the date of receipt by the Bureau.
§ 121.3a. Computation of time.
Except as otherwise provided by law, in computing a period of time prescribed or allowed by this chapter, the day of the act, event or default after which the designated period of time begins to run may not be included. The last day of the period so computed shall be included, unless it is Saturday, Sunday or a legal holiday in this Commonwealth, in which event the period shall run until the end of the next day which is neither a Saturday, Sunday nor a holiday. A part-day holiday shall be considered as other days and not as a holiday. Intermediate Saturdays, Sundays and holidays shall be included in the computation.
§ 121.3b. Posting workers' compensation information.
(a) An employer shall post workers' compensation information at its primary place of business and at its sites of employment in a prominent and easily accessible place, including, without limitation, areas used for the treatment of injured employees or for the administration of first aid. The workers' compensation information shall be posted in the same location as the notice required by section 305(e) of the act (77 P. S. § 501(e)).
(b) The information shall be entitled ''Workers' Compensation Information'' and include the following:
(1) The workers' compensation law provides wage loss and medical benefits to employees who cannot work, or who need medical care, because of a work-related injury.
(2) Benefits are required to be paid by your employer when self-insured, or through insurance provided by your employer. Your employer is required to post the name of the company responsible for paying workers' compensation benefits in the same area as this posting.
(3) If your employer has posted a list of six or more health care providers in your work place, you are required to visit one of them for your initial treatment, except for an emergency. Your employer is required to give you a notice of your rights and responsibilities for using the list of providers.
(4) You should report immediately any injury or work-related illness to your employer.
(5) Your benefits could be delayed or denied if you do not notify your employer immediately.
(6) If your claim is denied, you have the right to request a hearing before a workers' compensation judge.
(7) The Bureau of Workers' Compensation cannot provide legal advice. However, you may contact the Bureau of Workers' Compensation for additional general information at: Bureau of Workers' Compensation, 1171 S. Cameron St., Room 103, Harrisburg, Pennsylvania 17104-2501; telephone number within Pennsylvania (800) 482-2383; telephone number outside of Pennsylvania (717) 772-4447; TTY (800) 362-4228 (for hearing and speech impaired only); Website: www.state.pa.us, PA Keyword: workers comp.
(c) The information must be printed on paper no smaller than 81/2 x 11 inches and in font no smaller than 11 point.
§ 121.4. [Reproduction of forms] (Reserved).
[Printing samples of all Departmental forms will be provided upon request. Reproduction of these forms will be in accordance with guidelines accompanying the samples.]
§ 121.5. Reporting injuries to the Bureau.
(a) [Employers' reports of occupational injury or disease shall be filed directly with the Bureau of Occupational Injury and Disease Compensation, Department of Labor and Industry (Department), Harrisburg, Pennsylvania 17120 on Form OIDC-344, Employer's Report of Occupational Injury or Disease or on Form LIBC-375, Employer's Report of Industrial Injury Coal Mining, in accordance with section 438 of the Workers' Compensation Act (77 P. S. § 994).
(b) It shall be mandatory that the employer report to the Department all occupational injury and disease resulting in disability continuing more than the day, shift or turn in which the employe was injured. It shall also be mandatory that the employe receive, as soon as practicable, a copy of this report to be completed at least through item 30.
(c) For purposes of reporting injuries, a variance is granted under section 438 of the act to allow submission of the reports as late as ten days but no sooner than seven days from the date disability begins.
(d)] The [report shall be filed] employer shall file the Employer's Report of Occupational Injury or Disease, Form LIBC-344, with the [Department] Bureau as follows:
* * * * * (2) [Not before] Within 7 days [but no later than 10 days] after the date disability begins for all other injuries covered by section [435] 438 of the [Workers' Compensation Act] act (77 P. S. § [991] 994).
* * * * * (b) The employer shall send a copy of this report to the employee simultaneously with filing it with the Bureau.
(c) A disability that requires a report to the Bureau is defined as an injury only resulting in death or disability continuing the entire day, shift or turn, or longer, in which the injury was received.
[(e) Disability for the purposes of reporting to the Bureau shall be defined as loss of time or wages beyond the day, shift or turn in which the injury was received or the loss of a member, loss of use of a member or disfigurement which may qualify for a specific loss payment under section 306(c) of the Workers' Compensation Act (77 P. S. § 513).
(f) Before mailing the Bureau copy, the employer shall separately complete the bottom of that form.]
§ 121.6. [Supplemental reports] (Reserved).
[The Preprinted Computer Card, Form OIDC-493, will be mailed by the Department of Labor and Industry (Department) to the insurer or self-insurer. This will acknowledge receipt by the Department of an employer's report which either indicates lost time beyond the waiting period or is unclear as to the period of disability. It is to be completed and returned to the Department in compliance with the instructions printed thereon.]
§ 121.7. Notice of compensation payable and notice of temporary compensation payable.
(a) [Employer's Notice of Compensation Payable, Form OIDC-495, may be used as indicated under section 407 of the Workers' Compensation Act (77 P. S. § 731).] If an employer files a Notice of Compensation Payable, Form LIBC-495, or a Notice of Temporary Compensation Payable, Form LIBC-501, the employer shall do all of the following simultaneously and no later than 21 days from the date the employer had notice or knowledge of the disability:
(1) Send the Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, to the employee or the employee's dependent.
(2) Pay compensation to the employee or to the employee's dependent.
(3) File the Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, with the Bureau.
(b) [The employer shall submit the notice directly to the employe or the employe's dependent, with a copy to the Department, as soon as practicable, and in no event later than 21 days from the date the employer knew of injuries.
(c) The notice does not require the employe's signature.
(d) If compensation payable under the notice is less than the maximum rate, a statement of wage form, Form OIDC-494, shall accompany the notice showing a calculation of wages, where applicable, and rate of compensation.] A Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501.
(c) To modify a Notice of Temporary Compensation Payable, Form LIBC-501, an employer shall file an amended Notice of Temporary Compensation Payable, Form LIBC-501, with the Bureau during the 90-day temporary compensation payable period. The amended Notice of Temporary Compensation Payable, Form LIBC-501, shall be clearly identified as ''Amended.'' This subsection does not apply upon conversion of the Notice of Temporary Compensation Payable, Form LIBC-501, to a Notice of Compensation Payable, Form LIBC-495.
(d) The employer may file a Notice of Compensation Payable, Form LIBC-495, or a Notice of Temporary Compensation Payable, Form LIBC-501, based upon the employee's estimated wages if the employer has not obtained the wages necessary to properly calculate the employee's compensation payable. The estimated Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, shall be clearly identified as ''Estimated.''
(e) If the estimated wages or compensation is less than the employee's actual wages, the employer shall amend the estimated Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, upon receipt of the employee's actual wages. Amendments resulting in an increase in the employee's wage or compensation shall be filed with the Bureau under § 121.12 (relating to bureau review of agreements, notices of compensation payable and notices of temporary compensation payable). The employer shall file a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, under § 121.17(b) (relating to change in compensation) when there are changes resulting in a decrease in the employee's wage or compensation.
(f) In medical only cases, when an employee's injury has not resulted in lost time from work, an employer may file a Notice of Compensation Payable, Form LIBC-495.
§ 121.8. Agreements for compensation for disability or permanent injury.
(a) [All Agreements, Form LIBC-336, shall be completed before being signed. If any entry is made after the signature is affixed, the entire agreement may be nullified, at the option of the employe or his dependents.] An Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, shall be completed before being signed by the employer and the employee. If the employer and the employee enter into an agreement, the employer shall do all of the following simultaneously and not later than 21 days from the date the employer had notice or knowledge of the disability:
(1) Send the agreement signed by the employer and the employee to the employee.
(2) Pay compensation to the employee.
(3) File the agreement with the Bureau.
(b) [Wage information need not be shown unless the compensation payable thereon is less than themaximum allowed.] A Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336.
(c) If the employer has not obtained the wages necessary to properly calculate the employee's compensation payable, an Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, based upon the employee's estimated wages may be filed. The estimated Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, shall be clearly identified as ''Estimated.''
(d) If the estimated wages or compensation is not correct, the employer shall amend the estimated Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, upon receipt of the employee's actual wages. Amendments resulting in an increase in the employee's wage or compensation shall be filed with the Bureau under § 121.12 (relating to Bureau review of agreements, notices of compensation payable and notices of temporary compensation payable), and shall be clearly identified as ''Amended.'' The employer shall file a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, under § 121.17 (relating to change in compensation) when there are changes resulting in a decrease in the employee's wage or compensation.
§ 121.9. Agreements[--fatal cases] for compensation for death.
(a) If a compensable injury results in death, an Agreement [Form] for Compensation for Death, Form LIBC-338, shall be executed between [the] an employer and the [dependent,] deceased's dependents or [a] personal representative[; and a copy thereof shall be submitted to the Department of Labor and Industry as outlined under section 407 of the Workers' Compensation Act (77 P. S. § 731)] and filed with the Bureau.
(b) [Wage information shall be shown if the compensation payable thereon for any period is less than the maximum allowed.] A Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every Agreement for Compensation for Death, Form LIBC-338.
(c) If death results [within 7 days from the date of] from the injury, compensation payments to the [dependent] dependents for the death benefit shall begin from the date of the employee's death.
(d) [If death results more than 7 days after the injury, compensation payments covering the disability period should be paid as set forth in this chapter, and compensation payments because of death due to the injury shall start from the date of death.] If the employer has not obtained the wages necessary to properly calculate the employee's compensation payable, an Agreement for Compensation for Death, Form LIBC-338, based on the employee's estimated wages may be filed. The estimated Agreement for Compensation for Death, Form LIBC-338, shall be clearly identified as ''Estimated.''
(e) If the estimated wages or compensation is not correct, the employer shall amend the estimated Agreement for Compensation for Death, Form LIBC-338, on receipt of the employee's actual wages. Amendments resulting in an increase in the employee's wage or dependent's compensation shall be filed with the Bureau under § 121.12 (relating to Bureau review of agreements, notices of compensation payable and notices of temporary compensation payable), and shall be clearly identified as ''Amended.'' The employer shall file a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, under § 121.17 (relating to change in compensation) when there are changes resulting in a decrease in the employee's wage or compensation.
§ 121.10. [Supplemental agreements] (Reserved).
[(a) Supplemental Agreement, Form LIBC-337, shall be completed as necessary before being signed by both employer and claimant. This form shall be used to modify an agreement, notice of compensation payable or award.
(b) If the employe's disability is sufficient to entitle him to the maximum compensation payable under section 306(b) of the Workers' Compensation Act (77 P. S. § 512), no wage information need be given. The agreement shall then recite ''employe has returned to work, but suffers a loss of earning power sufficient to entitle him to the maximum compensation payable for partial disability,'' or words to that effect as the fact of each case warrant.
(c) If the employe has returned to work but is receiving less than the maximum compensation payable under section 306(b) of the act for partial disability, his wages before the injury, as fixed by the agreement or award, and the wages actually received after his return to work, shall be set forth. Payment of partial disability under this paragraph shall be made on the same periodic basis as other compensation is payable, except, and only where necessary, an initial period not to exceed 4 weeks, may be used to determine an average weekly wage for partial disability.]
§ 121.11. Supplemental agreements[--fatal] for compensation for death.
[Where the birth of a posthumous child, the remarriage of a widow or the death of a dependent changes the amount of compensation of the person or person to whom it is payable, but does not extinguish the employer's liability under an award or an agreement, a Supplemental Agreement, Form LIBC-339, should be executed by the surviving parent or guardian. The Department of Labor and Industry will presume that the surviving parent is guardian for purposes of receiving compensation under the act.]
(a) A Supplemental Agreement for Compensation for Death, Form LIBC-339, may be used to change an Agreement for Compensation for Death, Form LIBC-338, or an award. A Supplemental Agreement for Compensation for Death, Form LIBC-339, shall be completed before being signed by an employer and a deceased's dependents or personal representative.
(b) An Agreement for Compensation for Death, Form LIBC-338, may be changed for any of the following reasons:
(1) Birth of a posthumous child.
(2) A change in dependent's status, including death.
(3) A surviving spouse dies, remarries or becomes capable of self-support and any dependent children remain eligible for benefits.
(c) The Bureau will presume that the surviving parent is guardian for purposes of receiving compensation under the act.
(d) The completed Supplemental Agreement for Compensation for Death, Form LIBC-339, shall be sent to the all of the deceased's dependents or their personal representative and filed with the Bureau.
§ 121.12. [Department] Bureau review of agreements, [and] notices of compensation payable and notices of temporary compensation payable.
[If any facts in a compensation agreement, or in a notice of compensation payable, differ from facts stated in the injury report, and the Department of Labor and Industry (Department) cannot reasonably resolve the difference, the agreement or notice may be returned for correction. Errors in computing wages may be corrected without the execution of new agreements if the correction would result in an increase in the employe's wage or his compensation. This shall be accomplished by the submission of notice to the employe with a copy to the Department.]
(a) Errors in computing wages may be corrected by filing an amended version of the agreement, Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, with the Bureau if correction of errors would increase the employee's wage or compensation. The amended agreement, Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501, shall be clearly identified as ''Amended'' and may have only the insurer's signature.
(b) A Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every amended agreement, Notice of Compensation Payable, Form LIBC-495, or Notice of Temporary Compensation Payable, Form LIBC-501.
§ 121.13. Denial of compensation.
If compensation is controverted, a Notice of [Workmen's] Workers' Compensation Denial, Form LIBC-496, shall be sent to [employe] the employee or dependent and filed with the Bureau, fully stating the grounds upon which the right to compensation is controverted, [with a copy to the Department of Labor and Industry, no later than] within 21 days after notice or knowledge to the employer of [employe's] the employee's disability or death.
§ 121.14. Weekly wage[,] for occupational disease cases.
[The] For cases involving occupational diseases under the act, the weekly wage will be determined in accordance with section 309 of the [Workers' Compensation Act] act (77 P. S. § 582), and [will] a claimant's compensation rate shall be subject to the maximum compensation payable rate in effect at the date of last exposure.
§ 121.15. Compensation payable.
(a) In computing the time when the disability becomes compensable, the day the injured [employe] employee is unable to continue at work by reason of the injury shall be counted as the first day of disability in the 7 day waiting period. If the injured [employe] employee is paid full wages for the day, shift or turn on which the injury occurred, the following day shall be counted as the first day of disability. In determining the waiting period or time during which compensation is payable, each calendar day, including Sundays and holidays, shall be counted. In determining the period of disability, seven should be used as a divisor to determine the number [of weeks], and any part [thereof], of the weeks.
(b) If death results [within 7 days from the date of] from the injury, compensation payments to all of the [dependent] dependents for death benefits shall begin from the date of the employee's death.
(c) If death results more than 7 days after the injury, compensation payments covering the disability period should be paid as set forth in this chapter[;], and compensation payments because of death due to the injury shall start from the date of death.
* * * * * § 121.16. [Statement of compensation paid] Updating claims status.
(a) [As close as practicable to the anniversary date of injury or death, a Statement of Account of Compensation, Form LIBC-392, shall be filed annually with the Department of Labor and Industry (Department) on each open case, showing payments to date of filing.] All of the following apply to the Annual Claims Status Report, Form LIBC-774:
(1) The Bureau will provide the Annual Claims Status Report, Form LIBC-774, to an insurer each year before February 1.
(2) The insurer shall file a completed Annual Claims Status Report, Form LIBC-774, to the Bureau each year before April 16.
(3) If an insurance carrier fails to file the completed report, the Bureau may recommend that the Insurance Commissioner revoke or suspend the insurance carrier's license under section 441(a) of the act (77 P. S. § 997).
(4) If a self-insured employer fails to timely file the completed report, the Secretary of the Department may revoke or suspend the self-insured employer's privilege to carry its own risk under section 441(b) of the act.
(b) [If an agreement or notice of compensation payable provides solely for payment of compensation for a specific loss under section 306(c) of the Workers' Compensation Act (77 P. S. § 513), a Statement of Account of Compensation, Form LIBC-392, will be accepted by the Department as confirmation of final payment.
(c) If liability of an employer for death compensation has terminated because of remarriage of a widow or death of all dependents entitled to compensation, a Statement of Account of Compensation, Form LIBC-392, shall be submitted to the Department along with a certified copy of marriage certificate or death certificate, as the case may be.
(d) If the period for which death compensation payable by the employer has expired, Statement of Account of Compensation, Form LIBC-392, shall be filed with the Department as final payment confirmation.
(e) If compensation is terminated or suspended by decision of a referee, Workmen's Compensation Appeal Board or an appeal court or by original or supplemental agreement signed by the injured employe, a Statement of Account of Compensation, Form LIBC-392, shall be filed with the Department as confirmation of payment.
(f) If a statement of account of compensation is submitted under the requirements of the provisions of this chapter, it shall be signed by an authorized representative of the employer or insurer.] A Final Statement of Account of Compensation Paid, Form LIBC-392, shall be filed with the Bureau immediately after the final payment of compensation.
§ 121.17. [Termination] Change in compensation.
(a) [By final receipt. If an injured employe has recovered from his injury so that he has regained his full earning power, and so that all disability due to the injury has terminated, a final receipt may be fully prepared for signature. The fact that the employe returns to similar work at his original or greater wage unaccompanied by a showing that all disability has terminated is not a basis for a final receipt. However, it may be the basis for a suspension of compensation.] If an injured employee has recovered from an injury, or a deceased employee's dependent or personal representative is no longer eligible to receive death benefits, an Agreement to Stop Weekly Workers' Compensation Payments (Final Receipt), Form LIBC-340, may be filed with the Bureau.
(b) [By agreement. Termination may be accomplished by agreement to that effect signed by the employer and claimant. A suspension of compensation, rather than a complete termination, may also be accomplished by agreement between the parties.] Termination, suspension, modification or other change in compensation may be accomplished by filing with the Bureau a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337. A Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, may be used to change an Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, a Notice of Compensation Payable, Form LIBC-495, or an award. A Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, shall be completed before being signed by the employer and the employee. The completed Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, shall be sent to the employee or his dependents and filed with the Bureau.
(c) [By petition. If termination, or suspension, cannot be accomplished as indicated in subsection (a) or (b), the employer shall file petition for termination, or suspension, as provided under section 413 of the Workers' Compensation Act (77 P. S. § 774.2).] A suspension or modification of compensation may be accomplished by the employer mailing a Notification of Suspension or Modification Pursuant to §§ 413 (c) & (d), Form LIBC-751, to the Bureau and the employee. The wage calculation on the Notification of Suspension or Modification Pursuant to §§ 413 (c) & (d), Form LIBC-751, shall be completed for a modification.
(d) [By decision. If a decision of a Referee, Board or Appeal Court terminates the payment of compensation, no further documentation is required, except Statement of Account of Compensation, Form OIDC-392, showing total compensation paid.] If temporary payments made under § 121.7(a) (relating to notice of compensation payable and notice of temporary compensation payable) are stopped, the employer shall file a Notice Stopping Temporary Compensation, Form LIBC-502, and a Notice of Workers' Compensation Denial, Form LIBC-496, within 5 days of the last payment or file a Notice of Compensation Payable, Form LIBC-495, or file an Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336. The employer may not use a Notification of Suspension or Modification Pursuant to §§ 413 (c) & (d), Form LIBC-751, to stop temporary payments made under § 121.7.
(e) If termination, suspension or modification of compensation cannot be achieved through subsection (a), (b), (c) or (d), the employer may file a petition to: Terminate (stop payment of worker's compensation), Terminate (based upon physician's affidavit, a special supersedeas hearing to be scheduled), Modify or Suspend Compensation Benefits, Form LIBC-378.
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