Posted by Kathy Speaker MacNett on September 30, 2011

Three new forms will be necessary for Workers' Compensation purposes effective February 2011.

These forms are:

Form #/ Revision Date	Form Name	EPS Formats	Other Formats	OCR	# of sides	Duplex (Mandatory when yes)	Date Accepted	Date Required
LIBC-749 1-11	Death Claim Supplement to Compromise and Release Agreement	None	PDF	NO	2	No	1/1/2011	2/1/2011
LIBC-755 1-11	Compromise and Release Agreement	None	PDF	No	4	No	1/1/2011	2/1/2011
LIBC-337 12-10	Supplemental Agreement For Compensation	None	PDF	Yes	2	Yes	12/23/10	2/21/11

All three can be found among the online forms on the Pennsylvania Department of Labor & Industry's website at: http://www.portal.state.pa.us/portal/server.pt?open=514&objID=552595&mode=2.

BOTTOM LINE:  Since the purpose of these forms would be to end or adjust compensation, it is advantageous for employers to assure that the proper forms are utilized. 

Skarlatos & Zonarich LLP is a full-service law firm with highly skilled professionals dedicated to providing clients with sound advice and aggressive advocacy. For more information, visit skarlatoszonarich.com.

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