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PA · rules

Westmoreland Cnty. C.P. Civil Rules 12

If you are making a claim for medical benefits or lost income, have you received

activein force · 2025-10-06 – presentact-effective-date

or are you eligible to receive benefits from Workers’ Compensation or any

program, group contract, or other arrangement for payment of benefits as

defined by Title 75 P.S. §1719(b)? Answer “Yes” or “No”.

Provenance

Source
www.westmorelandcountypa.gov
Retrieved
2026-09-30
Edition
2026-09-30
Content hash
c7920e7e989fde2f74ef0f2fe951303c14a1988d1c7aec08eb56bb0e8ec1149e
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