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PENNSYLVANIA WORKERS 'COMPENSATION LAW - 2007 by crt16941

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									        PENNSYLVANIA WORKERS’ COMPENSATION LAW - 2007
        Pittsburgh Office                        Philadelphia Office                           Commonly Used Pennsylvania
     Serving western Pennsylvania:             Serving eastern Pennsylvania:
     Four Northshore Center                     531 Plymouth Road                              Workers’ Compensation Forms
       106 Isabella Street                           Suite 500                 LIBC-378 Petition To Form: Must be filed online with the bureau at
      Pittsburgh, PA 15212                  Plymouth Meeting, PA 19462
                                                                               http://www.dli.state.pa.us. Use for Termination, Modification, Suspension,
        412-995-3000 Ph                           610-832-1111 Ph
       412-995-3303 Fax                          610-941-1060 Fax              Seek Approval of C&R Agreement, Review Petition, Reinstatement
                                                                               Petition.
      West Virginia Office                        New Jersey Office
  The Maxwell Centre, Suite 200                        Suite 103               LIBC-374 Answer to Claim Petition: Must be filed by Defendant/
         32 20th Street                          502 Carnegie Center           Employer within 20 days of the judge’s circulation date of Notice of
      Wheeling, WV 26003                         Princeton, NJ 08540           Assignment of Petition, or will be barred from asserting a defense to any
       304-233-9500 Ph                             609-987-0616 Ph             allegations set forth in the claim petition.
       304-233-1363 Fax                           609-987-0070 Fax
                                                                               LIBC0-495 Notice of Compensation Payable: Circulate when a claim
New Act 109 of 2006-Compliance at Settlement:                                  has been formally accepted.

Claimant must execute an affidavit acknowledging the amount he/she is          LIBC-501 Notice of Temporary Compensation Payable: Generally pre-
currently in arrears in conjunction with any settlement of his claim. A lien   ferred if formal acceptance of denial of claim pending further investigation,
search must be conducted prior to the hearing and can be done at               but wish to comply with statutory 21-day acknowledgement of claim to
https://www.humanservices.state.pa.us/CSWS/index.aspx                          avoid potential future penalties.

It is strongly advised that if any child support order is in place, that the   LIBC-494C Statement of Wages: Should be prepared after acceptance
parties secure steps for the wage attachment to dissolve upon approval of      of a claim or during litigation on a claim petition.
the Compromise and Release Agreement.                                          LIBC-496 Notice of Workers’ Compensation Denial: Must file with
New Mandatory Mediation:                                                       Bureau within 21 days of knowledge of an injury or may face penalties for
                                                                               a late filing.
Effective November 9, 2006, all pending claims in litigation must include a
scheduled mediation conference with the presiding workers' compensa-           LIBC-751 Notification of Suspension/Modification: To take binding
tion judge prior to submission of closing memorandums. However, the            effect, must file within 7 days of the Claimant’s return to work with no
parties can stipulate on the record to the judge that mandatory mediation      wage loss, or residual wage loss.
is futile given the facts of the case.                                         LIBC-337 Supplemental Agreement: Used for modifying any terms of
                                                                               payment regarding the claim, or to memorialize any agreements by the
         Pennsylvania Workers’ Compensation Attorneys                          parties.
                           Current as of Mar. 1, 2007
                                                                               LIBC-757 Notice of Ability to Return to Work: Should be circulated
 Sondra L. Binotto . . . . . . . . .slbinotto@bwhllc.com   or   412-995-3189
                                                                               prior to any attempt to modify Claimant’s benefits per a physician report,
 Theresa M. Cignetti . . . . . . . .tcignetti@bwhllc.com   or   412-995-3187   and prior to any attempt to begin vocational placement. Must send via
 Theresa Garvin-Keyser . . . .tmkeyser@bwhllc.com          or   610-832-1111   certified mail to meet requirements of statutory notice.
 Tony A. Comas . . . . . . . . . . .tacomas@bwhllc.com     or   412-995-3180
 Christine R. Hardy . . . . . . . . .cbhardy@bwhllc.com    or   412-995-3240   LIBC-497 Physician’s Affidavit of Recovery: To be filled out by physi-
                                                                               cian when a Claimant is found to be fully recovered from a work injury.
 Valerie H. Lieberman . . .vhlieberman@bwhllc.com          or   610-832-2587
 Gerald R. O’Brien . . . . . . . . .grobrien@bwhllc.com    or   412-995-3194   LIBC-380 Third Party Settlement Agreement: When third-party litigation
 D. Scott Newman . . . . . . .dsnewman@bwhllc.com          or   412-995-3176   creates the right to a subrogation lien for Defendant/Employer, this form
 Christopher Pierson . . . . . . .cpierson@bwhllc.com      or   412-995-3172   will assist in the proper calculation of any lien or grace period for payment
 Travis W. Smith . . . . . . . . . . .twsmith@bwhllc.com   or   412-995-3174   of benefits.
Wage Calculations:                                                                                                                                      Maximum Compensation Rates 2001-2006
Average Weekly Wage (AWW): Assess wage records for the last four
13-week periods predating the work injury. Add the highest three (3) peri-                                                              2001 . . . . . . . . .$644                                                                2005 . . . . . . . .$716
ods and divide by 3. For inclusion of bonus, vacation pay or overtime,
take the total of bonus, vacation pay, or overtime, and divide by 52                                                                    2002 . . . . . . . . .$662                                                                2006 . . . . . . . .$745
weeks. If an individual worked less than a complete thirteen (13) week
calendar period, take the hourly pay and multiply by the hours expected                                                                 2003 . . . . . . . . .$675                                                                2007 . . . . . . . .$779
to work in one (1) week.
Temporary Partial Disability (TPD): Pre-injury AWW subtracted by the                                                                    2004 . . . . . . . . .$690
earnings after injury. The difference is then divided by three (3) and multi-
plied by two (2) to reach the TPD rate.                                                                                              Workers’ Compensation Claim -
Statute of Limitations                                                                                                               Relevant Time Periods at a Glance
Claimant’s Filing of Initial Claim: Within three (3) years of the date of                                                            Notice by Claimant to Employer of Injury—Within 120 days of the date
injury.                                                                                                                              of injury or within 120 days Claimant knew or reasonably should have
                                                                                                                                     known injury may be work-related.
Filing of an Appeal: Within twenty (20) days of receipt of decision and
order by Workers’ Compensation Judge or Workers’ Compensation                                                                        Filing Employer's Report of Occupational Injury or Disease—
Appeal Board.                                                                                                                        Employer shall report injury no more than 10 days from the date of dis-
                                                                                                                                     ability to the insurance carrier
Settlement of Workers’ Compensation Claims When
Claimant is Medicare-Eligible                                                                                                        Filing Notice of Compensation Denial or Temporary Notice of
                                                                                                                                     Compensation Payable—Within 21 days that Employer has notice or
If the settlement is greater than $25,000 and Claimant is over the age of
sixty-five (65) or had been receiving Social Security Disability Insurance                                                           knowledge of a work injury.
(SSDI) benefits in two (2) years, Medicare approval of Claimant’s settle-                                                            Notification of Suspension—Within seven (7) days of Claimant’s return
ment will be required.                                                                                                               to work without a loss of earnings or return to work with residual wage
If Claimant is not yet Medicare-eligible but has a reasonable expectation                                                            loss.
to become eligible for Medicare within the next thirty (30) months, and the
total value of settlement is greater than $250,000, Medicare approval will                                                           Impairment Rating Evaluation—Should take place within sixty (60) days
be required.                                                                                                                         of the date that Claimant receives his/her 104th week of temporary total
                                                                                                                                     disability benefits
NOTE: We are permitted to move forward with the C & R hearing prior to
CMS approval, if settlement terms adequately consider the same.                                                                      500 weeks—If benefits are modified, at the expiration of 500 weeks,
                                                                                                                                     Claimant is no longer entitled to indemnity benefits absent a showing that
Recommended in C&R Agreements - Future Medical
                                                                                                                                     his/her condition has worsened. Medical expenses are still covered.
Allocation
Even if Claimant is not presently eligible for Medicare, the current trend
and recommendation is to reasonably consider Medicare’s interest in
settlement by allocating a portion of the lump sum to represent the future                                                            Questions? Need information? www.bwhllc.com
value of work-related medical treatment.

                                                                      Burns, White & Hickton Regional Coverage Areas
                                                                                PA Workers’ Compensation
                                           Erie


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                                                                                                        Fulton        Franklin                                                                                                           County &
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120606BWHWC                                                                                                                                                     Philadelphia Office
                                                         Pittsburgh Office

								
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