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Pennsylvania Employee Verification of Employment Self-Employment Or Change In Physical Condition

State:
Pennsylvania
Control #:
PA-SKU-4616
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PDF
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Description

Employee Verification of Employment Self-Employment Or Change In Physical Condition

Pennsylvania Employee Verification of Employment Self-Employment Or Change In Physical Condition is a form provided by the Pennsylvania Department of Labor and Industry that is used to verify employment, self-employment, or changes in physical condition of employees in the state. It is required to be completed by employers when verifying an employee's work history, self-employment status, or changes in physical condition due to illness or injury. The form contains information about the employee's work history, job duties, and wages earned. It is important to note that the form must be completed by the employer, not the employee. The two main types of Pennsylvania Employee Verification of Employment Self-Employment Or Change In Physical Condition are Verification of Employment and Verification of Self-Employment or Change in Physical Condition. The Verification of Employment form is used to verify an employee's work history and is required for all employers in Pennsylvania. The Verification of Self-Employment or Change in Physical Condition form is used to verify an employee's self-employment status or any changes in physical condition due to illness or injury. This form is required for employers who do not offer health insurance coverage or who have employees with a pre-existing medical condition.

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FAQ

If your employer cannot give you work that meets the work restrictions, the claims administrator must pay temporary total disability benefits (see Chapter 5). If you have questions or need help, use the resources in Chapter 10. Don't delay, because there are deadlines for taking action to protect your rights.

Under Section 307 of the Pennsylvania Workers' Compensation Act, in situations where a person is fatally injured in the course and scope of employment, compensation benefits are payable to the survivors of that person, typically, the widow/widower and their children.

Injured employees are entitled to employer-paid medical treatment and, if cumulative period(s) of disability exceed seven days, wage-loss benefits. Wage-loss benefits must commence within 21 days of the employer's knowledge or notice of injury, unless the claim is denied within that time period.

The proposed employer assessment factor is 0.0318. This factor, in concert with the proposed employer assessment procedure, is subject to approval by the Insurance Commissioner.

» Frequently Asked Questions » Can An Employee Be Fired While On Workers' Compensation? Pennsylvania law allows employers to fire or lay off workers while they have an open workers' compensation claim, but the employer must have a reason that shows they are not retaliating for the injury claim.

Section 319 of the Pennsylvania Workers' Compensation Act provides the statutory authority for the Employer to subrogate to a third party action. The Employer's subrogation interest is a creature of statute, as opposed to an equitable or contractual right to subrogation.

If you resign or quit your job while on workers' compensation, your former employer must continue to pay for medical treatment that is reasonable and necessary to the injury.

Does Your Pennsylvania Employer Have to Hold Your Job Position While You Recover? No, Pennsylvania law does not require employers to hold workers' job positions while they recover from work-related injuries except as provided under the Family Medical Leave Act.

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Pennsylvania Employee Verification of Employment Self-Employment Or Change In Physical Condition