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of the Commonwealth of Pennsylvania

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    Report the Suspension or Modification of Workers' Compensation Benefits

    Use this form to report changes or stops in Workers' Compensation benefits. Complete it, send it to the employee, and upload to WCAIS or mail to the Bureau of Workers’ Compensation within seven days. Also, submit an EDI transaction to match the LIBC-751 to update the claim status in WCAIS.

     

    If an employee disagrees with the outcome, they have 20 days from receiving the form to challenge it. Go to www.WCAIS.pa.gov, choose "File a WCOA Petition," link the claim number, select "Employee Challenge Petition (LIBC-751)."

     

    Or, check the box on the paper form you received, sign, and mail to: PA Department of Labor & Industry, Workers’ Compensation Office of Adjudication (WCOA), 1010 N 7th Street, Suite 202, Harrisburg, PA 17102-1400.

    Report the Suspension or Modification of Workers' Compensation Benefits by mail

    Use this form to report changes or stops in Workers' Compensation benefits. Also, submit an EDI transaction to match the LIBC-751 to update the claim status in WCAIS.

    Begin the process here.

    Report today by clicking the link below.

    Start here.

    Frequently Asked Questions

    Some of the more frequently asked questions about Workers' Compensation are addressed here. For more information, please contact BWC directly.

    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.

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    By phone

    Hearing impaired individuals can contact BWC by dialing 7-1-1 and providing the relay service with BWC's phone number.

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    By email

    You can email questions to BWC.

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    By mail

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

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