Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 6342 (October 1, 2022).

34 Pa. Code § 121.13. Denial of compensation.

§ 121.13. Denial of compensation.

 If compensation is controverted, a Notice of Workers’ Compensation Denial, Form LIBC-496, shall be sent to the employee or dependent and filed with the Bureau, fully stating the grounds upon which the right to compensation is controverted, within 21 days after notice or knowledge to the employer of the employee’s disability or death.

Source

   The provisions of this §  121.13 amended August 3, 2007, effective August 4, 2007, 37 Pa.B. 4181. Immediately preceding text appears at serial pages (255594) and (305087).

Notes of Decisions

   Accrual

   The employer’s notice of compensation denial was not merely 6 days late, but rather 21 days late, since the operative date is not the date written on the LIBC-496 form, but rather the date on which the employer sent the form to the claimant; a plain reading of this regulation indicates that an employer has not ‘‘submitted’’ a notice of compensation denial until it is mailed, or the employer has otherwise dispatched the LIBC-496 form to the claimant. Lemon v. Workers’ Compensation Appeal Board (Mercy Nursing Connections), 742 A.2d 223 (Pa. Cmwlth. 1999); appeal denied 753 A.2d 822 (Pa. 2000).

   Estoppel

   Where employer failed to file a Notice of Workmen’s Compensation Denial within 21 days after notice of the employe’s disability (as required by this section) and began making compensation payments, it was estopped to disavow its acceptance of liability. Mosgo v. Workmen’s Compensation Appeal Board (Tri-Area Beverage, Inc.), 480 A.2d 1285 (Pa. Cmwlth. 1984).

   Reasonable Contest

   Where the only evidence supporting employer’s claim of reasonable contest was testimony of doctor who examined claimant after hearings had begun and several months after the employer had denied compensation benefits, there was no basis to reverse Board’s determination that employer’s contest was not reasonable. Jones & Laughlin Steel Corp. v. Workmen’s Compensation Appeal Board (White), 500 A.2d 494 (Pa. Cmwlth. 1985).



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