Pennsylvania 7. Statement of Intent to Proceed is a form that employers must fill out in order to begin a workers’ compensation claim in the state of Pennsylvania. This form must be filled out in its entirety and must include the employer's name, address, and contact information; the employee's name, address, and contact information; the date of injury or illness; and a detailed description of the injury or illness. The employer must also certify that the employee is eligible for workers’ compensation benefits. There are two types of Pennsylvania 7. Statement of Intent to Proceed: the Original Statement and the Supplemental Statement. The Original Statement must be filled out and submitted within 21 days of the injury or illness, while the Supplemental Statement can be filled out and submitted at any time after the Original Statement has been filed.
Pennsylvania 7. Statement of Intent to Proceed is a form that employers must fill out in order to begin a workers’ compensation claim in the state of Pennsylvania. This form must be filled out in its entirety and must include the employer's name, address, and contact information; the employee's name, address, and contact information; the date of injury or illness; and a detailed description of the injury or illness. The employer must also certify that the employee is eligible for workers’ compensation benefits. There are two types of Pennsylvania 7. Statement of Intent to Proceed: the Original Statement and the Supplemental Statement. The Original Statement must be filled out and submitted within 21 days of the injury or illness, while the Supplemental Statement can be filled out and submitted at any time after the Original Statement has been filed.
