DE Dept of Labor Message 7.11.13
Delaware Office of Workers’ Compensation (OWC)
Health Care Payment System (HCPS)
Please do not respond to this ListServ e-mail.
If you have any additional questions, feel free to call (302-761-8200) or e-mail
( hcpaymentquestions@state.de.us ) the Delaware Office of Workers’ Compensation, Medical Component.
REVISED “AGREEMENT AS TO COMPENSATION PAID” FORM NOW AVAILABLE ONLINE
Pursuant to 19 Del. C. 2322E(d) and effective 6/27/13, OWC has published a revised “Agreement as to Compensation Paid” form. The form is available through the OWC website athttp://dia.delawareworks.com/workers-comp/forms.php. Proposed changes to the “Employer’s Modified Duty Availability Report” are currently moving through the regulatory process. In the meantime, continue to use the Employer’s Form currently available on the OWC website at http://dowc.ingenix.com/info.asp?page=forms.
19 Del. C. §2322E(d):
(d) Within 14 days of the issuance of an Agreement As To Compensation to an employee for any period of total disability, the employer shall provide to the health care provider/physician
most responsible for the treatment of the employee’s work-related injury and to the employer’s insurance carrier, if applicable, a report of the modified-duty jobs which may be available to the employee. The insurance carrier for an insured employer shall send to such employer the aforementioned report for completion, and shall be independently responsible for providing a completed report of modified-duty jobs to the health care provider/physician. The health care provider portion of the employer’s modified duty availability report must be signed and returned by the health care provider within 14 days of the next date of service after receipt of the form from the employer, but not later than 21 days from the health care provider’s receipt of such form.
Please call (302-761-8200) or e-mail hcpaymentquestion@state.de.us, if you have questions concerning this message.
Sincerely,
Donna Forrest
Medical Component Manager, Delaware Office of Workers’ Compensation
4425 N. Market St., 3rd Floor, Wilmington, DE 19802
Phone: 302-761-8200 Fax: 302-761-6601 hcpaymentquestions@state.de.us
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