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  • Application For Supersedeas Fund Reimbursement ...

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Social Security Number: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY BUREAU OF WORKERS' COMPENSATION 1171 S. CAMERON STREET, ROOM 103 HARRISBURG PA 17104-2501 (TOLL FREE) 800-482-2383.

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Workers' compensation coverage is mandatory for most employers under Pennsylvania law. Employers who do not have workers' compensation coverage may be subject to lawsuits by employees and to criminal prosecution by the commonwealth.

Under the Pennsylvania Workers' Compensation Act, injured workers are entitled to wage loss (“indemnity benefits”) based on the earnings at the time of injury. Generally speaking, indemnity benefits are calculated based on two-thirds (2/3) of your average weekly wage (“AWW”).

Workers' Comp Exemptions in Pennsylvania Sole-Proprietors and Partners who include themselves on workers' compensation coverage must use a minimum payroll amount of $54,548 and a maximum amount of 135,200 for rating their overall workers' compensation cost.

Pursuant to the Workers' Compensation Act, Section 105.1, the Department of Labor & Industry has determined the statewide average weekly wage for injuries occurring on and after Jan. 1, 2023, shall be $1,273.00 per week.

A Supersedeas means the insurance company is trying to suspend or even eliminate your workers' compensation wage benefits. You need your wage benefits to pay your bills. This means a Supersedeas is a very serious event in your compensation claim.

Workers' Compensation is tax-free. In Pennsylvania, the weekly compensation rate amounts to 66% of the injured worker's average weekly wage if they earned between $810.76 and $1,621.50 prior to the injury. For workers who earn between $600.56 and $810.75, the weekly compensation rate is $540.50.

Form LIBC-344 First Report of Injury (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of a work-related injury. Fatalities must be reported within 24 hours.

The weekly compensation rate is to be 66 2/3 percent of the employee's average weekly wage falls between $1,695.00 and $847.51. The weekly compensation rate is $565.00 if the employee's average weekly wage is between $847.50 and $627.78, and 90 percent of the employee's average weekly wage if it is $627.77 or less.

How to File a Workers' Compensation Claim in PA Inform Your Employer of Your Injury. ... Seek Immediate Medical Attention. ... File Your Claim With the Pennsylvania Department of Labor and Industry. ... Fill Out All the Required Workers' Compensation Claim Forms.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232