- Act 195 Interest Arbitration Invoice {PLRB-52}
- Act 88 Arbitration Invoice {PLRB-26}
- Agreement For Compensation For Death {LIBC-338}
- Agreement For Compensation For Disability Or Permanent Injury {LIBC-336}
- Agreement To Stop Weekly Workers Compensation Payments (Final Receipt) {LIBC-340}
- Annual Report Of Accident And Illness Prevention Program Status {LIBC-230G}
- Annual Report Of Accident And Illness Prevention Program Status Self Insured {LIBC-220E}
- Answer To Petition For Commutation {LIBC-35}
- Answer To Petition To {LIBC-377}
- Appeal From Judges Finding Of Fact {LIBC-25-26}
- Application For Benefits Under Section 909 {LIBC-118}
- Application For Executive Officer Exception {LIBC-509}
- Application For Fee Review Pursuant To Section 306 (F.1) {LIBC-507}
- Authorization For Alternative Delivery Of Compensation Payments {LIBC-10}
- Authorization To Release Information-Verification Or Information {LIBC-552}
- Charge Of Unfair Labor Practices {PLRB-15}
- Charge of Unfair Practices {PERA-9}
- Child Support Lien Affidavit {LIBC-504}
- Claim Petition For Additional Compensation From Subsecquent Injury Fund {LIBC-375}
- Claim Petition For Benefits From Uninsured Employer Guaranty Fund And Uninsured Employer {LIBC-550}
- Claim Petition For Workers Compensation {LIBC-362}
- Claimants Statement
- Commutation Of Compensation {LIBC-498}
- Compromise And Release Agreement {LIBC-755}
- Conciliation Invoice {PERA-50}
- Death Claim Supplement To Compromise And Release Agreement {LIBC-749}
- Defendants Answer To Claim Petition Under Pennsylvania Occupational Disease Act {LIBC-364B}
- Defendants Answer To Claim Petition Under Pennsylvania Workers Compensation Act {LIBC-374}
- Defendants Answer To Occupational Disease Claim Petition Section 301(i) Only {LIBC-524}
- Dismemberment Chart (Foot) {LIBC-134F}
- Dismemberment Chart (Hand) {LIBC-134}
- Electronic Data Interchange First Report Of Injury {LIBC-90}
- Electronic Data Interchange First Report Of Injury {LIBC-90}
- Electronic Data Interchange Subsequent Report Of Injury {LIBC-91}
- Employee Report Of Wages And Physical Condition {LIBC-750}
- Employee Verification Of Employment Self-Employment Or Change In Physical Condition {LIBC-760}
- Employees Affidavit And Waiver Of Workers Compensation Benefits And Statement Of Religious Sect {LIBC-14B}
- Employees Report Of Benefits For Offsets {LIBC-756}
- Employers Insurance Information Sheet {LIBC-500}
- Executive Officers Declaration {LIBC-513}
- Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund {LIBC-351}
- Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund {LIBC-352}
- Fact Finding Invoice {PERA-47}
- Fatal Claim Petition For Compensation By Dependents Of Deceased Employees {LIBC-363}
- Final Statement Of Account Of Compensation Paid {LIBC-392A}
- Group Self-Insurance Fund Member Annual Contribution Worksheet Form {LIBC-350}
- Impairment Rating Determination Sheet {LIBC-767}
- Informal Conference Agreement Form {LIBC-754}
- Initial Report Of Accident And Illness Prevention Program Status {LIBC-231G}
- Insurers Annual Report Of Accident And Illness Prevention Services {LIBC-210I}
- Insurers Initial Report Of Accident And Illness Prevention Services {LIBC-211I}
- Interested Party Update Request {LIBC-113}
- Joint Election Request {PERA-3}
- Joint Request For Certification {PERA-1}
- Notice Medical Treatment For Work Injury Or Occupational Illness
- Notice Of AbilityTo Return To Work {LIBC-757}
- Notice Of Change Of Workers Compensation Disability Status {LIBC-764}
- Notice Of Claim Against Uninsured Employer {LIBC-551}
- Notice Of Reinstatement Of Workers Compensation Benefits {LIBC-763}
- Notice Of Request For An Informal Conference {LIBC-753}
- Notice Of Suspension For Failure To Return Form LIBC-760 {LIBC-762}
- Notice Of Workers Compensation Benefit Offset {LIBC-761}
- Notice To Claimant {LIBC-758}
- Notification Of Suspension Or Modification Pursuant To Section 413 (C) And (D) {LIBC-751}
- Occupational Disease Claim Petition {LIBC-396}
- Petition (Police, Fire And Private Sector) {PLRB-13}
- Petition For Commutation {LIBC-34}
- Petition For Joinder Of Additional Defendant {LIBC-376}
- Petition For Physical Examination Or Expert Interview Of Employee (Section 314) {LIBC-499}
- Petition For Review Of Utilization Review Determination {LIBC-603}
- Petition To {LIBC-378}
- Petition Under The Public Employe Relations Act {PERA-4}
- Physicians Affidavit Of Recovery {LIBC-497}
- Qualifications Of Reviewer {LIBC-131}
- Request For Appointment Of Fact-Finding Panel {PLRB-25}
- Request For Hearing To Contest Fee Review Determination {LIBC-606}
- Request For Panel Of Neutral Interest Arbitrators {PLRB-57}
- Section 304.2 Application For Religious Exception Of Specified Employes {LIBC-14A}
- Self-Insured Employers Initial Report Of Accident Prevention Program {LIBC-221I}
- Statement Of Wages (For Injuries Occurring On And After June 24, 1996) {LIBC-494C}
- Statement Of Wages (For Injuries Occurring On Or Before June 23 1996) {LIBC-494A}
- Subpoena {LIBC-480}
- Supplemental Agreement For Compensation For Disability Or Permanent Injury {LIBC-337}
- Supplemental Agreement Form Compensation For Death {LIBC-339}
- Supplemental Information Addendum To Annual Report Of Runoff Group Self-Insurance Fund {LIBC-371}
- Supplemental Information Addendum To Application As A Group Workers Compensation Fund {LIBC-369}
- Supplemental Information Addendum To Group Sel-Insurance Fund Annual Report {LIBC-365}
- Supplemental Information Addendum To Group Workers Compensation Fund {LIBC-368}
- Third Party Settlement Agreement {LIBC-380}
- Utilization Review Determination Face Sheet {LIBC-604}
- Utilization Review Request {LIBC-601}
- Workers Compensation Medical Report Form {LIBC-9}