The Pennsylvania Dismemberment Chart (Foot) is a medical chart used to evaluate the severity of amputation injuries involving the feet. This chart is used to assess the amount of disability for the purposes of determining a patient's future medical care, as well as the potential for future disability payments. The Pennsylvania Dismemberment Chart (Foot) is divided into four categories: Total, Partial, Great Toe and Other Toes. Each category is assigned a numerical value, with higher numbers indicating a greater degree of disability. Total amputation of the foot is given a score of 100, while partial amputation of the foot is given a score of 50. Amputation of the great toe is assigned a score of 20, while amputation of other toes is assigned a score of 10. The total score is used to determine the level of disability and the amount of compensation awarded.
Pennsylvania Dismemberment Chart (Foot)
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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 Employer's First Report of Injury or Illness provides information on the claimant, employer, insurance carrier and medical practitioner necessary to begin the claims process. Details of the claimant's employment and circumstances surrounding the injury or illness are also requested.
In Pennsylvania, you have 120 days to inform your employer that you have been injured at work. This is the first step in receiving workers' compensation benefits.
If the insurance company or employer accepts your claim, then you can expect workers' compensation checks within roughly 28 days of your date of injury.
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.
Specific loss payments in Pennsylvania are paid out to the injured worker under the condition that you lost a body part or lost the ability to use the body part in question. The amount is based upon the body part that was lost or damaged and how much time you will miss from work due to the injury.