Pennsylvania Code (Last Updated: April 5, 2016) |
Title 34. LABOR AND INDUSTRY |
PART VIII. Bureau of Workers Compensation |
Chapter 121. General Provisions |
Section 121.8. Agreements for compensation for disability or permanent injury
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(a) An Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, shall be completed before being signed by the employer and the employee. If the employer and the employee enter into an agreement, the employer shall do all of the following simultaneously and not later than 21 days from the date the employer had notice or knowledge of the disability:
(1) Send the fully-executed agreement to the employee.
(2) Pay compensation to the employee.
(3) File the agreement with the Bureau.
(b) A Statement of Wages, Form LIBC-494A, or Statement of Wages, Form LIBC-494C, shall be filed with every Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336.
(c) If the employer has not obtained the wages necessary to properly calculate the employees compensation payable, an Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, based upon the employees estimated wages may be filed. The estimated Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, shall be clearly identified as Estimated.
(d) If the estimated wages or compensation is not correct, the employer shall amend the estimated Agreement for Compensation for Disability or Permanent Injury, Form LIBC-336, upon receipt of the employees actual wages.
(1) Amendments resulting in an increase in the employees wage or compensation shall be filed with the Bureau under § 121.12 (relating to Bureau review of agreements and notices of compensation payable), and shall be clearly identified as Amended.
(2) The employer shall file a Supplemental Agreement for Compensation for Disability or Permanent Injury, Form LIBC-337, under § 121.17 (relating to change in compensation) when there are changes resulting in a decrease in the employees wage or compensation.
The provisions of this § 121.8 amended August 3, 2007, effective August 4, 2007, 37 Pa.B. 4181. Immediately preceding text appears at serial page (255593).