34 Pa. Code § 121.11. Supplemental agreements for compensation for death.

§ 121.11. Supplemental agreements for compensation for death.

(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, shall 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 all of the deceased’s dependents or their personal representative and filed with the Bureau.

Source

   The provisions of this §  121.11 amended August 3, 2007, effective August 4, 2007, 37 Pa.B. 4181. Immediately preceding text appears at serial page (255594).

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