What is a LIBC-750? What do I have to report to the Workers’ Compensation Insurance Company?
The Pennsylvania Workers’ Compensation Act says that an injured worker is required to report “regularly” to the WC insurance company the receipt of unemployment benefits, wages received in employment or self employment, “old age” Social Security Retirement benefits, pension and severance benefits.
Usually, the Workers’ Compensation insurance company will send the claimant a Verification Form (LIBC-750) asking these questions. Failure to return the completed form will result in the suspension of Workers’ Compensation payments.
The form can be confusing because the same form is used for all claimants receiving Workers’ Compensation in Pennsylvania; thus, not all of the questions may apply to each case. A good “rule of thumb” is to answer the questions simply and honestly.
Failure to report wages earned while receiving Workers’ Compensation could result in a criminal fraud prosecution.
It is very important that this form is filled out on time and filled out accurately. For this reason, it is a good idea to consult with an experienced workers’ compensation attorney before trying to fill out a form that you might not understand. If you have any questions, the legal team at Calhoon and Kaminsky can answer them for free. Call us at 717-695-4722.