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of the Commonwealth of Pennsylvania

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    Report an Agreement for Supplemental Compensation for Death

    Supplemental death benefits offer your survivors additional protection against unexpected loss of income. If approved, this protection is in addition to the original death benefit.

    Report an Agreement for Supplemental Compensation for Death by mail

    Report an Agreement for Compensation for Death

    The Pennsylvania Workers’ Compensation Act offers death benefits for fatalities that happen in the workplace. While no amount of money can replace a loved one, it's important to note that Pennsylvania Workers’ Comp does provide death benefits.

    The agreement must be clearly filled out and uploaded following the guidelines in the EDI Implementation Guide. Complete wage information as per Section 309 of the Pennsylvania Workers’ Compensation Act, and send it to the Dependent/Guardian/Personal Representative.

    To begin the process, click here.

    Report today by clicking the link below.

    Start here

    Frequently Asked Questions

    Contact Us

    Helpline voice telephone numbers:toll free in Pennsylvania: 800-482-2383 local and outside Pennsylvania: 717-772-4447. Hearing impaired individuals, or those who have difficulty speaking, may contact the PA Department of Labor & Industry’s Bureau of Workers’ Compensation by dialing 7-1-1 and providing the relay service with the bureau’s phone number 717-772-4447.

    By phone

    For general questions, contact BWC.

    Call BWC (opens in a new tab)

    By phone

    For general questions, contact BWC.

    Hearing impaired individuals can contact BWC by dialing 7-1-1 and providing the relay service with BWC's phone number. (opens in a new tab)

    By email

    You can email questions to BWC.

    Email BWC (opens in a new tab)

    By mail

    You can send questions or paper applications to: Bureau of Workers' Compensation 651 Boas Street, 8th Floor Harrisburg, PA 17121