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Workers Compensation Frequently Asked Questions

When is my indemnity check mailed? 
Indemnity checks are mailed on a bi-weekly basis.

What is a third party administrator?  
A third party administrator provides claims administration services to the Security Fund.  These services include managed care services, auditing provider services, invoices, and coordination with Security Fund outside counsel on matters of litigation. 

Why does the Commonwealth send my check when the third party administrator handles my claim? 
fter your workers' compensation carrier became insolvent, the Security Fund became responsible for your claim payments.  The Security Fund is administered in the Bureau of Special Funds within the Pennsylvania Insurance Department, a Commonwealth agency. The third party administrator is responsible for making recommendations for payment by the Security Fund to each claimant.  All payments are made through the Commonwealth payment system.

Why does my attorney still get part of my check?  
Attorney fees are generally agreed upon by you and your attorney or by a workers' compensation judge.  Any questions regarding whether your attorney should continue to receive a portion of your benefits should be referred directly to your attorney.

When can payment be expected on a medical invoice?  
Recommendation for payment is submitted to the Security Fund by your adjuster after all supporting medical documentation is provided.  Payment is typically made within 30 days after the recommendation is received.

Why don't you pay all of my doctors bills?  
Workers' compensation benefits are provided for medical treatment related to your work related injury only.  Any medical treatment not directly related to your injury will not be paid.

Why do I have to go to your doctor every couple of months?  
The Security Fund may require and schedule you to attend an independent medical evaluation every six months if necessary to clarify your medical status.

Why can't I talk to my old adjuster from my previous insurance carrier?  
Your previous insurance company has been liquidated and all claims handling functions are administered by the third party administrator and overseen by the Security Fund.

How do I request a Compromise and Release (C&R) settlement of my workers' compensation case?  
You or your attorney should submit a settlement demand to your assigned adjuster.  The adjuster will review your demand and send it with a recommendation to the Security Fund.  The Security Fund will provide the adjuster with a decision indicating whether to settle the case and the amount of settlement.  The adjuster will contact you or your attorney with the Security Fund's decision.