34 Pa. Code § 121.7 - Notice of compensation payable
(a)
If an employer files a Notice of Compensation Payable, Form LIBC-495, the
employer shall do all of the following simultaneously and no later than 21 days
from the date the employer had notice or knowledge of the disability:
(1) Send the Notice of Compensation Payable,
Form LIBC-495, to the employee or the employee's dependent.
(2) Pay compensation to the employee or to
the employee's dependent.
(3) File
the Notice of Compensation Payable, Form LIBC-495, with the Bureau.
(b) A Statement of Wages, Form
LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every
Notice of Compensation Payable, Form LIBC-495, except a Statement of Wages,
Form LIBC-494A, or Statement of Wages, Form LIBC-494C, may not be filed with
either of the following:
(1) An estimated
Notice of Compensation Payable, Form LIBC-495, filed under subsection
(c).
(2) A Notice of Compensation
Payable, Form LIBC-495, filed under subsection (e).
(c) The employer may file a Notice of
Compensation Payable, Form LIBC-495, based upon the employee's estimated wages
if the employer has not obtained the wages necessary to properly calculate the
employee's compensation payable. The estimated Notice of Compensation Payable,
Form LIBC-495, shall be clearly identified as "Estimated."
(d) If the estimated wages or compensation is
not correct, the employer shall amend the estimated Notice of Compensation
Payable, Form LIBC-495, upon receipt of the employee's actual wages in one of
the following ways:
(1) Amendments resulting
in an increase in the employee's wage or compensation shall be filed with the
Bureau under §
121.12 (relating to Bureau review
of agreements and notices of compensation payable), and shall be clearly
identified as "Amended" and may have only the insurer's signature.
(2) The employer shall file a Supplemental
Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337,
under §
121.17 (relating to change in
compensation) when there are changes resulting in a decrease in the employee's
wage or compensation.
(e) In medical only cases, when an employee's
injury has not resulted in lost time from work, an employer may file a Notice
of Compensation Payable, Form LIBC-495.
Notes
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