What are the Workers Compensation LIBC Employment Verification forms?

Pennsylvania injured workers get tons of paperwork in the mail, especially when they are in litigation of their workers compensation claim.  They get tons of documents from the Pennsylvania Department of Labor & Industry, from the insurance carrier, from their employer, and from their attorney.

There are a few documents you should know about and understand the importance in completing and returning these forms in a timely manner.  They are Employee verification forms, specifically, LIBC 750 (Employees Report of Wages), LIBC 756 (Employees Report of Benefits), and LIBC 760 (Employees Verification of Benefits).   [If you misplaced them, call the insurance carrier forn new copies or download them here.]  You may have a tendency to walk those forms over to your trash can, and place them in the trash can.  Do so at your own risk.

Pennsylvania injured workers who are receiving wage loss benefits are required to complete these forms when forwarded by the workers compensation insurance carrier.  Failure to complete and return can lead to a complete suspension of your wage loss benefit checks.  These forms are required under the anti-fraud provisions of the PA Workers’ Compensation Act.  The Act permits insurance carriers certain credits on wage loss benefits for any wages or certain potential benefits, earned after a work injury.  You must truthfully and accurately verify that you are not or are receiving other income. Completing these forms and failing to report income could result in fraud criminal charges.

So what do you do when you receive these forms in the mail?  Complete them truthfully and accurately, make copies for yourself, and then send them to the carrier by certified mail.  If you are  a client of Mooney & Associates, we encourage you to bring the forms into our office and lets us return them to the insurance carrier and/or defense counsel.  That way we can be assured the forms were returned appropriately to the insurance carrier.  It really is that simple.  A suspension of benefits for failure to return such forms is really not necessary.

If you do not understand the forms or wish to have Mooney & Associates handle the forms for you, just drop them off at one of our Central Pennsylvania offices or simply give me a call at 717-200-HURT.   Mooney & Associates offers FREE consultation or new clients and only represent injured workers on a contingency fee basis, meaning, we only collect if you collect.  Of course, if you are a current client, there is NEVER a charge to come and see me.