Employee Verification Forms

If you are receiving workers’ compensation benefits, you may have received Employee Verification forms in the mail from your insurer. It is critical that you do not ignore these forms. Your benefits can legally be stopped by the insurance company if you do not fill them out and return them.

Verification forms exist under the anti-fraud provisions of the Workers’ Compensation Act. As most injured workers know, the carrier enjoys a credit for any wages earned after a work injury. The premise behind verification forms is that an injured worker who is receiving wage loss benefits must report any earned wages to the carrier. You must verify that you are not receiving other income to continue to receive full benefits. Completing these forms and failing to report income could give rise to criminal charges.

So, the carrier has the right to send out these forms every six months. They can send any combination of three available forms: Employee Verification of Employment (LIBC-760); Employee Report of Wages (LIBC-750) and Employee’s Report of Benefits (LIBC-756). If you do not return a form LIBC-760 within 30 days of receipt, the carrier actually has the right to stop your benefits until you return it. Even then, your benefits will only restart as of the day the carrier gets it back from you.

Here’s a problem claimants sometimes face: the LIBC-750 and LIBC-760 forms are very nearly identical, posing almost exactly the same questions. Some people think they simply got two copies of the same form. Remember though, the carrier can only stop payments if you don’t return the 760. An unreturned 750 does not pose the same danger. It’s therefore critical to return both — not just one — of these forms; you could wind up returning only the 750. If the 760 isn’t returned, your benefits can be stopped.

So, what do you do once you receive these forms?

They will ask if you are employed or have been employed while receiving workers’ compensation. Answer honestly. The 750 and 760 will ask if your condition has changed. This is the most poorly worded question on these forms as it fails to ask “since when?”. However, if you have, say, recently undergone surgery, here is the place you’d mention that. The LIBC-756 will ask you if you have received Social Security retirement income, pension or unemployment benefits. Again, answer honestly. If you have any questions, check with your attorney.

Once you have completed your forms, make copies for your file. You can use them as a reference next time you get the forms. Next, send them to the carrier by certified mail with a return receipt (green card) requested. This will serve as proof of receipt if the carrier alleges it never got them back. This simple care and attention can prevent the unnecessary disruption of your benefits.

Quick Connect

This field is for validation purposes and should be left unchanged.


The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.