When you are receiving Pennsylvania workers’ compensation benefits, your employer’s workers’ compensation carrier is entitled to find out if you are working during your receipt of workers’ compensation benefits or if you are receiving certain types of benefits. Pennsylvania workers’ compensation falls under the PA Department of Labor & Industry Bureau of Workers’ Compensation.
Pennsylvania workers’ compensation is twofold, where you can receive both wage loss benefits and medical benefits. As the workers’ compensation carrier is paying wage loss benefits out on a weekly basis, they are entitled to a credit for any earnings or certain benefits received by a workers’ compensation injured worker.
To help the workers’ compensation carriers, the Bureau developed forms which are further discussed at www.dli.pa.gov . There are three (3) forms which are typically sent out by the workers’ compensation adjustors to workers’ compensation injured workers, also referred to as “claimants”. These forms are the “Employee Report of Wages and Physical Condition” (LIBC-750) form, the “Employee’s Report of Benefits for Offsets” (LIBC-756) form, and the “Employee Verification of Employment, Self-Employment or Change in Physical Condition” (LIBC-760) form.
These forms ask you to disclose whether you have been employed or self-employed while receiving workers’ compensation benefits, if your condition has changed in any way, and whether you have received unemployment compensation, social security (old age), severance or pension benefits while receiving workers’ compensation benefits, to name a few questions.
These forms must be completed by the claimant, signed, dated, and returned back to the adjustor or attorney who sent them out within thirty (30) days, or the claimant’s workers’ compensation wage loss benefits could be suspended, as well as possible prosecution for fraud under Article XI of the Workers’ Compensation Act.
If you are receiving PA workers’ compensation benefits and receive these forms in the mail, it is best to consult with an experienced workers’ compensation attorney to help you properly complete these forms and make sure that they are returned in a timely manner to the workers’ compensation carrier. If the forms are not returned within the thirty (30) day time period, but returned after, suspended benefits should be reinstated upon the workers’ compensation carrier’s receipt of the completed, signed, and dated forms.
These forms are not an option, but must be completed, and completed honestly to ensure that you and your workers’ compensation benefits are not in jeopardy. Full disclosure is definitely the best policy.