Once an injury is reported, there are several documents that you may see regarding your workers' compensation claim. Below is a summary of the documents that you should be familiar with:
Notice of Compensation Payable (NCP):This document provides the injured worker the greatest protection and provides for payment of both lost wage and medical benefits. Once an NCP is issued, the insurance carrier may not stop payment of lost wage or medical benefits without a Judge's order, your return to work without a wage loss, or an agreement between the parties.
Statement of Wages.The Statement of Wages outlines the calculation of the injured worker's Average Weekly Wage (AWW)and workers’ compensation rate. This document shows you how much you will be getting paid.
Temporary Notice of Compensation Payable (TNCP):This document provides for payment of lost wage and medical benefits. However, the TNCP may be revoked within 90 days and a denial issued. If 90 days elapse, this converts by operation of law to a NCP
Medical Only Notice of Compensation Payable:This allows insurance carriers to accept liability for a work injury and pay medical bills without agreeing to pay lost wage benefits.
Notice of Denial:The insurance carrier denies acceptance of the work injury. No lost wage or medical benefits will be paid. The injured worker must file a claim petition with the Pennsylvania Workers' Compensation Bureau and litigate the case in front of a Workers' Compensation Judge. It is highly recommended that you contact an attorney immediately should your claim be denied.
Authorization for Medical Records: This form authorizes the release of your medical records to the insurance company so they can review them in the claims process.
Employee Verification Form: This form is to report any earnings you may have received from alternate employment. Significantly, this form must be returned with 30 of receipt or you could have your benefits suspended for failing to return the form.
Supplemental Agreement: This form would act as a supplement to the NCP and can be used to report partial earning. This form can also indicate that your benefits are being terminated, so it is very important to review this document with an experienced workers’ compensation attorney.
Final Receipt: The employer may ask you to sign a final receipt indicating that you are fully recovered from the work injuries in an attempt to terminate your benefits. Signing a Final Receipt is an acknowledgement by the employee that he or she has fully healed from the work injury and has returned to work without a wage loss. This form can have dire consequences so it is vital that you understand exactly what you are giving up by signing this document.
Because each of these documents have different rights and consequences associated with it; you should discuss your claim, and any paper work you may receive, with an experienced workers' compensation attorney.