Libc 344 2026

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The document is an Employer's Report of Occupational Injury or Disease form from the Commonwealth of Pennsylvania's Department of Labor and Industry. It is used to report details regarding an employee's work-related injury or illness, including personal information about the employee, specifics of the injury, treatment received, and employer information. The form must be completed accurately and submitted to the Bureau of Workers' Compensation.

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Click ‘Get Form’ to open the libc 344 in the editor.
Begin by entering the employee's Social Security Number at the top of the form. This is crucial for identification purposes.
Fill in the date of injury, including month, day, and year. Ensure accuracy as this information is vital for processing claims.
Complete the employee's personal details: first name, last name, address, city, state, zip code, county, and phone number.
Indicate the employee's gender and marital status by selecting either male or female and married or single options.
Provide employment details such as occupation/job title and employment status (full-time, part-time, etc.).
Continue filling out employer information including name, address, SIC code, FEIN, and contact details.
In the injury section, specify type of injury code and describe how the injury occurred in detail. Include any relevant safety equipment used.
Finally, review all entries for completeness before submitting your form through our platform for free.

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2001	4.8 Satisfied (233 Votes)

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What is the workers compensation rate in Pennsylvania?

The maximum compensation rate is based on the statewide average weekly wage (AWW). It is \u2154 of the AWW....Maximum Compensation Rate. YearMaximum Compensation RateChange in Rate from Previous Year2020$1,081+3.05%2019$1,049+2.34%2018$1,025+3.02%2017$995+1.74%2 more rows

Do subcontractors need workers comp in PA?

No, in most cases, independent contractors working for your business do not require workers' compensation insurance. You will have to prove the contractor is not an employee, and if you cannot provide this documentation, then you may be required to pay workers' comp insurance fees for them.

Who is exempt from workers compensation in Pennsylvania?

Exemptions include: people covered under other workers' compensation acts, such as railroad workers, longshoremen and federal employees; domestic servants (coverage is optional); agricultural workers who work fewer than 30 days or earn less than $1,200 in a calendar year from one employer; and employees who have ...

pa wcais login

LIBC 344 First Report of Injury LIBC-495 LIBC 756 LIBC-337 LIBC 764 LIBC-494C LIBC 500 form LIBC-765

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Are sole proprietors required to have workers comp in PA?

Sole proprietors with no employees are not required to carry workers' compensation insurance. However, detailed information must be provided to your insurer to prove that the individual is a true independent contractor.

How is workers compensation calculated in Pennsylvania?

Workers' compensation payments are not a fixed amount. Instead, they are calculated based on a workers' average weekly wage. An average weekly wage generally amounts to about two-thirds the amount a worker earned before their injury. There are exemptions made during the calculation of a worker's average weekly wage.

How much do you get paid on workers comp in PA?

The maximum weekly compensation rate for calendar year 2019 in Pennsylvania is $1,049.00. The weekly compensation rate is to be 66 2/3 percent of the employee's average weekly wage falls between $1,573.50 and $786.76.

How is workers comp calculated?

Most often, benefits are calculated and paid based on the average weekly wage. This is calculated by multiplying the employee's daily wage by the number of days worked in a full year. That number is then divided by 52 weeks to get the average weekly wage.

How long does an employer have to file a workers comp claim in PA?

Employee Compensation Benefits Wage-loss benefits must commence within 21 days of the employer's knowledge or notice of injury, unless the claim is denied within that time period.

Libc 344 2026

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Do subcontractors need workers comp in PA?

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Are sole proprietors required to have workers comp in PA?

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How is workers comp calculated?

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