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PHILADELPHIA SOUTH COUNTY PENNSYLVANIAUpdated 05/30/2019-Page 1 of 2NOTICE TO EMPLOYEES IN CASE OF CORRELATED INJURIES ERIE INSURANCE GROUP 100 Erie Insurance Place, Erie, PA 16530 18004580811 1.
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How to fill out philadelphia south wc panel

01
Obtain the necessary information such as employer name, address, and phone number.
02
Fill in the injured worker's personal information including name, address, and social security number.
03
Provide details of the injury such as date and time of occurrence, nature of injury, and body part affected.
04
Include any witnesses to the incident and their contact information if available.
05
Sign and date the form before submitting it to the appropriate authorities for processing.

Who needs philadelphia south wc panel?

01
Employees who have been injured on the job in the Philadelphia South area.
02
Employers who are required to report workplace injuries to the workers' compensation panel.
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The Philadelphia South WC Panel is a form used in the Philadelphia area for reporting workers' compensation claims and related information.
Employers and insurance carriers involved in workers' compensation claims in the Philadelphia South area are required to file this panel.
To fill out the Philadelphia South WC Panel, one must enter specific information regarding the workers' compensation claim, including details about the injured worker, the incident, and relevant employer data.
The purpose of the Philadelphia South WC Panel is to standardize the reporting process for workers' compensation claims, ensuring that all necessary information is captured for review and processing.
The panel requires information such as the injured worker's name, claim number, date of injury, type of injury, employer details, and medical treatment information.
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