Supplemental Agreement For Compensation For Disability Or Permanent Injury {LIBC-337} | Pdf Fpdf Docx | Pennsylvania

 Pennsylvania   Workers Comp 
Supplemental Agreement For Compensation For Disability Or Permanent Injury {LIBC-337} | Pdf Fpdf Docx | Pennsylvania

Last updated: 4/3/2024

Supplemental Agreement For Compensation For Disability Or Permanent Injury {LIBC-337}

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Description

LIBC-337 -- SUPPLEMENTAL AGREEMENT FOR COMPENSATION FOR DISABILITY OR PERMANENT INJURY. This form is used by the Pennsylvania Department of Labor & Industry, Bureau of Workers' Compensation to document any changes in the status of an employee's disability resulting from a work-related injury. The form includes detailed information about the employee, employer, injury details, insurer or third-party administrator information, compensation details, and any further matters agreed upon by both parties. www.FormsWorkflow.com

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