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Pennsylvania Employee's Affidavit and Waiver of Workers' Compensation Benefits and Statement of religious Sect

State:
Pennsylvania
Control #:
PA-SKU-4542
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PDF
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Employee's Affidavit and Waiver of Workers' Compensation Benefits and Statement of religious Sect

Pennsylvania Employee's Affidavit and Waiver of Workers' Compensation Benefits and Statement of religious Sect is a form that employees in the State of Pennsylvania must fill out in order to receive workers' compensation benefits. This form is a legally binding document that allows the employee to waive any rights to workers' compensation benefits, and also provides an opportunity for the employee to declare their religious sect. There are two types of Pennsylvania Employee's Affidavit and Waiver of Workers' Compensation Benefits and Statement of religious Sect; one for those employees whose religious beliefs prohibit them from receiving workers' compensation benefits, and another for those employees who have religious beliefs that do not prohibit them from receiving workers' compensation benefits. The form must be signed in the presence of a notary public and witnessed by two people of the same religion as the employee. The employee must provide proof of their religious sect when signing the form. Upon signing, the employee will be able to receive workers' compensation benefits in accordance with their religious beliefs.

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FAQ

Section 305(d) provides: ?when any employer fails to secure the payment of compensation under this act as provided in sections 305 and 305.2, the injured employee or his dependents may proceed either under this act, or in a suit for damages at law as provided by Article II.?

SECTION 306 (f.1)(1)(i) Should invasive surgery for an employee be prescribed by a physician or other health care provider so designated by the employer, the employee shall be permitted to receive an additional opinion from any health care provider of the employee's own choice.

Section 306(a. 2) of the WC act requires the insurer to request an impairment rating evaluation within 60 days of the employe's receipt of 104 weeks of total disability benefits. The Department has interpreted this section to allow an insurer to request an evaluation 60 days prior to the expiration of the 104 weeks.

Under Section 307 of the Pennsylvania Workers' Compensation Act, in situations where a person is fatally injured in the course and scope of employment, compensation benefits are payable to the survivors of that person, typically, the widow/widower and their children.

Section 311 of the Pennsylvania Workers' Compensation Act provides that notice of a work injury must be given to an employer within 120 days or it is barred.

SECTION 306 (f.1)(1)(i) The employer shall provide payment in ance with this section for reasonable surgical and medical services, services rendered by physicians or other health care providers, including an additional opinion when invasive surgery may be necessary, medicines and supplies, as and when needed.

SECTION 302(a): A contractor who subcontracts all or any part of a contract and his insurer shall be liable for the payment of compensation to the employees of the subcontractor unless the subcontractor primarily liable for the payment of such compensation has secured its payment as provided for in this act.

SECTION 306 (f.1)(1)(i) The employer shall provide payment in ance with this section for reasonable surgical and medical services, services rendered by physicians or other health care providers, including an additional opinion when invasive surgery may be necessary, medicines and supplies, as and when needed.

More info

Employer's Affidavit of Exception from Workers' Compensation Benefits (WC-138-5). Who can receive Workers Compensation (WC) benefits?Even when workers' compensation coverage is not required, it's often in the employer's best interest to provide coverage. Employee Best Practices. 12 - IV REASONABLE ACCOMMODATION. A sole proprietor does not need to fill out waiver forms to be exempt from coverage. Must an injured worker notify his employer if he accepts other employment while receiving Temporary Total Disability benefits? Government under section 3 ;. Discount Energy Group.

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Pennsylvania Employee's Affidavit and Waiver of Workers' Compensation Benefits and Statement of religious Sect