The Pennsylvania Notice of Claim Against Uninsured Employer is a form used by employees in Pennsylvania to report a workplace injury or illness to an uninsured employer. This form is used by employees to ensure that they receive the proper compensation for their injury or illness. It is important to note that this form is not a substitute for filing a workers' compensation claim, and it is not a guarantee of benefits. Pennsylvania Notice of Claim Against Uninsured Employer is broken down into two types: 1. Notice of Claim Against Uninsured Employer: This form is used by employees in Pennsylvania to provide notice to their uninsured employer that they have suffered a workplace injury or illness. The form includes information about the employee’s injury or illness, the date of the injury or illness, and the employer’s contact information. 2. Employer’s Report of Uninsured Employer Claim: This form is used by employers in Pennsylvania to report a workplace injury or illness to the Department of Labor and Industry. The form includes information about the employee’s injury or illness, the date of the injury or illness, and the employer’s contact information. This form must be submitted within 15 days of receiving the employee’s Notice of Claim Against Uninsured Employer.