Bureau Documents

Controlling Document

reflects the current status of benefits

Notice of Compensation Payable (NCP)

- accepts claim for wage loss and medical benefits

- issuing is an admission of liability

Medical Only Notice of Compensation Payable (MO-NCP)

- accepts claim for medical benefits ONLY

- issuing is an admission of liability for related medical costs

Notice of Temporary Compensation Payable (TNCP)

- temporarily accepts claim while employer / carrier investigates

- issued when initiating benefits for no longer than 90 days

- does not guarantee full claim benefits

Medical Only Notice of Temporary Compensation Payable (MO-TNCP)

- temporarily accepts claim for medical benefits ONLY while employer / carrier investigates

- issued when initiating benefits for no longer than 90 days

- does not guarantee full claim benefits

Notice of Conversion of Temporary Compensation Payable to Compensation Payable

- converts TNCP to NCP

- claim is officially accepted

- issued when insurance did not file within 90 day period

Notice Stopping Temporary Compensation Payable

- issued during 90 day period of a TNCP

- Notice of Compensation Denial should immediately follow

Notice of Compensation Denial

- officially denies the claim, reason must be specified

- no benefits will be paid unless ordered by a judge through litigation

Statement of Wages

- used to calculate the injured workers Average Weekly Wage (AWW) and benefit rate

- must be filed with every TNCP or NCP

Supplemental Agreement for Compensation for Disability or Permanent Injury

- updates compensation due to a change in disability status

- must be agreed and signed by BOTH parties

Notification of Suspension or Modification

- filed when wage loss benefits are being reduced or stopped

- often based on alleged return to work

- claimant may challenge by filing Challenge Petition

- does not affect medical benefits

Notice of Suspension Failure to Return Form LIBC - 760

- filed when claimant fails complete and return employee verification forms within 30 days

- allows suspension of wage loss benefits until returned

- does not affect medical benefits

- once LIBC - 760 form is returned, carrier must file Notice of Reinstatement

Judges Decision

- issued at conclusion of litigation when WCJ rules on issues of a claim

- decision is legally binding unless appeal by one of the parties

- may impact benefits