4 Pa. Code § 115.6 - Processing of claims and payment of benefits

The processing of claims for compensation and the payment of benefits shall be governed by the following provisions:

(1) The State Director shall submit all claims formally filed on Compensation Claims-Accidental Injury Sustained by Duly Enrolled Emergency Management Volunteer [Form PEMA-A-CC-1, together with supporting documents, to the Bureau of Workman's Compensation of the Department of Labor and Industry for review and recommendation. The Bureau shall then make a formal report of its findings on Review of Compensation Claim-Accidental Injury Sustained by Duly Enrolled Emergency Management Volunteer (Form PEMA-A-CC-2).

(2) The Pennsylvania Emergency Management Agency shall fix the total amount of the due, just and legally permissible benefits to be paid to each duly enrolled civil defense volunteer as compensation for accidental injury sustained while engaged in authorized civil defense or disaster training, test or operational activities. Such amount shall be based upon a detailed examination of each formally filed Compensation Claim, Form PEMA-A- CC-1, together with due consideration of pertinent recommendations made by the Bureau of Workman's Compensation.

(3) The Pennsylvania Emergency Management Agency shall pay the amount of due, just and legally permissible compensation benefits directly to the injured volunteer, or to his estate, in the case of fatal injury.

(4) Upon receipt of benefits paid under the provisions of this chapter, the volunteer, or the executor or other authorized representative of his estate, shall execute an official Receipt for Compensation Benefits Paid (Form PEMA-A-CC-4 to the Pennsylvania Emergency Management Agency. The receipt shall indicate whether the payment received is partial, partial and final, or full and final settlement on the claim filed.

(5) Persons receiving benefits under the provisions of this chapter shall be responsible for the settlement of all obligations for medical, hospital and other expenses which may be incurred in connection with the treatment of injuries sustained.

Notes

4 Pa. Code § 115.6