| Title |
Last Updated |
| Employees Affidavit And Waiver Of Workers Compensation Benefits And Statement Of Religious Sect |
May 17, 2018 |
| Application For Fee Review Pursuant To Section 306 (F.1) |
May 17, 2018 |
| Answer To Petition For Commutation |
May 17, 2018 |
| Appeal From Judges Finding Of Fact |
March 27, 2018 |
| Electronic Data Interchange Subsequent Report Of Injury |
May 9, 2016 |
| Child Support Lien Affidavit |
November 30, 2015 |
| Notice Of Workers Compensation Denial |
June 4, 2015 |
| Notice Of Temporary Compensation Payable |
May 8, 2015 |
| Notice Of Compensation Payable |
May 8, 2015 |
| Notice Of Change Of Workers Compensation Disability Status |
January 30, 2015 |
| Interested Party Update Request |
November 13, 2014 |
| Notice Of Workers Compensation Benefit Offset |
April 2, 2014 |
| Impairment Rating Evaluation Appointment |
February 28, 2014 |
| Request For Designation Of A Physician To Perform An Impairment Rating Evaluation |
February 28, 2014 |
| Self-Insured Employers Initial Report Of Accident Prevention Program |
January 14, 2014 |
| Group Self-Insurance Fund Member Annual Contribution Worksheet Form |
January 14, 2014 |
| Initial Report Of Accident And Illness Prevention Program Status |
January 14, 2014 |
| Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund |
January 14, 2014 |
| Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund |
January 14, 2014 |
| Electronic Data Interchange First Report Of Injury |
January 13, 2014 |
| Annual Report Of Accident And Illness Prevention Program Status |
January 13, 2014 |
| Statement Of Wages (For Injuries Occurring On Or Before June 23 1996) |
October 10, 2013 |
| Notice Stopping Temporary Compensation |
October 9, 2013 |
| Notice Of Change Of Workers Compensation Disability Status |
October 9, 2013 |
| Impairment Rating Determination Face Sheet |
October 9, 2013 |
| Statement Of Wages (For Injuries Occurring On And After June 24 1996) |
September 27, 2013 |
| Notice To Claimant |
June 27, 2011 |
| Claimants Statement |
March 10, 2011 |
| Death Claim Supplement To Compromise And Release Agreement |
March 2, 2011 |
| Request For Appointment Of Fact-Finding Panel |
January 6, 2011 |
| Subpoena |
November 23, 2010 |
| Notice Medical Treatment For Work Injury Or Occupational Illness |
November 8, 2010 |
| Petition Under The Public Employe Relations Act |
May 5, 2009 |
| Petition (Police, Fire And Private Sector) |
May 5, 2009 |
| Joint Request For Certification |
May 5, 2009 |
| Joint Election Request |
May 5, 2009 |
| Charge of Unfair Practices |
May 5, 2009 |
| Charge Of Unfair Labor Practices |
May 5, 2009 |
| Application For First Report Of Injury Electronic Submission |
October 31, 2007 |
| Application For Supersedeas Fund Reimbursement |
September 18, 2007 |
| Statement Of Account Of Compensation Paid |
October 25, 2006 |
| Employers Application To Elect Domestic Employees To Come Within Provisions Of The Wokers Compensations Act |
July 21, 2006 |
| Answer To Petition For Commutation |
July 20, 2006 |
| Fatal Claim Petition For Compensation By Dependents For Death Resulting From Occupational Disease |
September 21, 2005 |
| Petition For Penalties |
April 1, 2005 |
| Fatal Claim Petition For Compensation By Dependents For Death Covered By The Pennsylvania Occupational Disease Act |
April 1, 2005 |
© 2025 Justia
