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    Report a Third-Party Settlement Agreement

    Send a report to reclaim past benefits and receive credit against future ones for work-related injuries.

    Report online here
    Report by mail

    Report a Third-Party Settlement Agreement

    If an injured worker receives compensation from a third party for injuries related to a work accident, the employer may reclaim past medical or indemnity benefits paid on behalf of the worker. Additionally, the employer may receive credit against any future indemnity benefits owed to the employee. The Bureau offers a step-by-step form to determine the repayment and future credit, including an assessment of the employer's portion of third-party fees and costs.

    Frequently Asked Questions

    You can fill the form out online or through the mail.

    Use this guide to help you understand the Workers' Compensation claim process.

    Contact Us

    Helpline voice telephone numbers:toll free in Pennsylvania: 800-482-2383local and outside Pennsylvania: 717-772-4447 Hearing impaired individuals, or those who have difficulty speaking, may contact the PA Department of Labor & Industry’s Bureau of Workers’ Compensation by dialing 7-1-1 and providing the relay service with the bureau’s phone number (717-772-4447).

    By phone

    For general questions, contact BWC.

    Call BWC

    By phone

    Hearing impaired individuals can contact BWC by dialing 7-1-1 and providing the relay service with BWC's phone number.

    717-772-4447

    By email

    You can email questions to BWC.

    Email BWC

    By mail

    You can send questions or paper applications to: Bureau of Workers' Compensation 651 Boas Street, 8th Floor Harrisburg, PA 17121