Workers’ Compensation

The Workers’ Compensation Injury Packet includes the current panel of authorized providers. You are required to complete, read, and sign all attached forms.

• Workers’ Compensation Occupational Injury/Incident Report (All questions must be answered completely, including specific detail, i.e., identifying the exact injured area along with where, when, and how the injury occurred.)
• List of Authorized Panel Providers.
• Employee’s Rights & Duties Under Section 306 (F.l) of The Pennsylvania Workers’ Compensation Act.
• Authorization to Release, Use, and Disclose Protected Health Information.

All of the forms listed above must be completed and returned to Human Resources within 48 hours, or you may be required to provide a written statement, explain the reason why it was reported late, and provide an eyewitness verification. The completed forms can be placed in the inter-district mail to Kelly Burkholder, Employee Benefits Administrator, delivered to Human Resources in the Education Center, or emailed to [email protected].

Lost Time: Lost time due to a work-related injury must be immediately reported to Kelly Burkholder, Employee Benefits Administrator, (610)861-0500, extension 60210, or emailed to [email protected].