§ 121.7. Notice of compensation payable.
(a) If an employer files a Notice of Compensation Payable, Form LIBC-495, 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, to the employee or the employees dependent.
(2) Pay compensation to the employee or to the employees dependent.
(3) File the Notice of Compensation Payable, Form LIBC-495, with the Bureau.
(b) 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, except a Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, may not be filed with either of the following:
(1) An estimated Notice of Compensation Payable, Form LIBC-495, filed under subsection (c).
(2) A Notice of Compensation Payable, Form LIBC-495, filed under subsection (e).
(c) The employer may file a Notice of Compensation Payable, Form LIBC-495, based upon the employees estimated wages if the employer has not obtained the wages necessary to properly calculate the employees compensation payable. The estimated Notice of Compensation Payable, Form LIBC-495, shall be clearly identified as Estimated.
(d) If the estimated wages or compensation is not correct, the employer shall amend the estimated Notice of Compensation Payable, Form LIBC-495, upon receipt of the employees actual wages in one of the following ways:
(1) Amendments resulting in an increase in the employees wage or compensation shall be filed with the Bureau under § 121.12 (relating to Bureau review of agreements and notices of compensation payable), and shall be clearly identified as Amended and may have only the insurers signature.
(2) 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 employees wage or compensation.
(e) In medical only cases, when an employees injury has not resulted in lost time from work, an employer may file a Notice of Compensation Payable, Form LIBC-495.
Source The provisions of this § 121.7 amended August 3, 2007, effective August 4, 2007, 37 Pa.B. 4181. Immediately prececding text appears at serial page (255593).
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