Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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Pennsylvania Code



Subchapter F. EMPLOYE REPORTING AND VERIFICATION REQUIREMENTS


Sec.


123.501.    Reporting requirement.
123.502.    Verification.

§ 123.501. Reporting requirement.

 An insurer shall notify the employe of the employe’s reporting requirements under sections 204 and 311.1(a) and (d) of the act (77 P. S. § §  71 and 631.1(a) and (d)). In addition, the insurer shall provide the employe with the forms required to fulfill the employe’s reporting and verification requirements under section 311.1(d) of the act.

§ 123.502. Verification.

 (a)  Insurers may submit Form LIBC-760, ‘‘Employee Verification of Employment, Self-employment or Change in Physical Condition,’’ to the employe and employe’s counsel, if known, to verify, no more than once every 6 months, that the status of the employe’s entitlement to receive compensation has not changed.

 (b)  Form LIBC-760 shall be delivered to the employe in person or consistent with section 406 of the act.

 (c)  The employe shall complete and return form LIBC-760 to the insurer within 30 days of receipt of the form.

 (d)  If the employe fails to comply with subsection (c), the insurer may suspend payments of wage-loss benefits until Form LIBC-760 is returned by the employe.

 (e)  To suspend payments of compensation due to the employe’s failure to comply with subsection (c), the insurer shall provide written notice to the employee, the employee’s counsel, if known, and the Department, on Form LIBC-762, ‘‘Notice of Suspension for Failure to Return Form LIBC-760 (Employee Verification of Employment, Self-employment or Change in Physical Condition)’’ of the following:

   (1)  The workers’ compensation benefits have been suspended because of the employee’s failure to return the verification form within the 30-day statutorily prescribed time period.

   (2)  The workers’ compensation benefits shall be reinstated by the insurer, effective upon receipt of the completed verification form.

   (3)  The employee has the right to challenge the suspension of benefits by filing a petition for reinstatement with the Department.

 (f)  Upon receipt of the completed verification form, the insurer shall reinstate the workers’ compensation benefits for which the employee is eligible. The insurer shall provide written notice to the employee, employee’s counsel, if known, and the Department, on Form LIBC-763, ‘‘Notice of Reinstatement of Workers’ Compensation Benefits,’’ that the employee’s workers’ compensation benefits have been reinstated due to the return of the completed verification form. The notice shall further indicate the date the verification form was received by the insurer and the date of reinstatement of the workers’ compensation benefits.

 (g)  Employees are not entitled to payments of workers’ compensation during periods of noncompliance with subsection (c).

Notes of Decisions

   Suspension of Benefits

   Suspension of benefits for failure to comply with the requirement to file a verification, does not constitute an impermissible automatic supersedeas. Suspension is appropriate; however, benefits should be reinstated upon compliance. Reinstatement requires payment of benefits from the date of reinstatement, and not retroactively to the date of suspension. Farance v. Workers’ Compensation Appeal Board, 774 A.2d 785 (Pa. Cmwlth. 2001), appeal denied 788 A.2d 380 (Pa. 2001).



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