This is one of the official workers' compensation forms for the state of Pennsylvania.
Pennsylvania General Petition for Workers' Compensation
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Description General Petition Form
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FAQ
A Penalty Petition is filed for an allegation that the employer/insurer violated the Pennsylvania Workers' Compensation Act. In many cases, it stems from a late payment of an indemnity (wage loss) check or failure to pay a medical bill.
Resolving workers' compensation disputes through a formal claim petition. People who are injured on the job or who acquire an illness or disease through their work do not have to prove fault by their employers to receive compensation for their medical care and related expenses.
Inform Your Employer of Your Injury. Seek Immediate Medical Attention. File Your Claim With the Pennsylvania Department of Labor and Industry. Fill Out All the Required Workers' Compensation Claim Forms.
Make Sure Your Workers' Comp Claim Is Legitimate. If Your Claim Is Denied, File an Appeal. Notify Your Employer and File Your Worker's Comp Claim. Seek Medical Treatment. Take Advantage of Your Disability Benefits. Keep a Record of Everything. Prepare for an Independent Medical Exam.
In Pennsylvania, you have 120 days to let your employer know that you suffered a work injury. You have 3 years from the day you were injured to file a claim petition for an injury.
Not all claims end with a settlement, but most claims where there is a permanent disability as a result of the injury do end with a settlement. If you return to work for your employer and have no permanent disability as a result of your injury...
Your job duties are to examine the documentation, determine whether compensation is appropriate, and if so, the compensation amount. A claims examiner reviews your claims to ensure that all parties follow proper guidelines and workers' comp laws.
Adjudication of any claim or objection is appealable like a decree.Inasmuch as this paper is confined to 'Claim petitions', it is seminal to refer to the meaning of 'adjudication'.
A workers' compensation settlement is an agreement on the medical benefits and other benefits available to an injured worker. Benefits include lost wages in the form of temporary disability, permanent damage from an injury in the form of permanent disability, and medical care for the injured part(s) of the body.