The CAO will use the Reimbursement Referral (OIG 173) to inform the TPL-Casualty Unit in BFO or to the OSIG of a potential claim. The CAO will contact the OSIG by telephone when an individual receives personal property and has money to pay the claim.
The OIG 173 is the primary source of information to compute the reimbursement claim amount. The CAO will make the referral immediately when it learns of the need for such action. The CAO will not wait until the individual actually receives the personal property. A delay in submitting the OIG 173 may prevent the collection of the reimbursement claim from the individual or negotiating a settlement with the representative responsible for disbursing the personal property.
PO14625915 Changes to the Reimbursement Referral Form (Linked February 21, 2009)
The CAO will complete the OIG 173 according to instructions in Appendix B, “Completion of the OIG 173.” The form may be typed or handwritten in ink. Different reimbursement actions require individual OIG 173 referrals. The CAO should attach to the OIG 173 , the signed reimbursement form when appropriate (e.g. FIRM 176-K, PA 198-S) and any documents used to verify the personal property, such as an award letter. The TPL-Casualty Unit in BFO or the OSIG will return the form to the CAO for correction if it is incomplete.
The CAO will send the OIG 173 for reimbursement codes 04 and 08 (personal injury and worker’s compensation) to:
Department of Human Services
TPL-Casualty Unit
P.O. Box 8486
Harrisburg, PA 17105-8486
The CAO will send all other OIG 173 referrals to:
OSIG
Reimbursement Recovery Section
P.O. Box 8016
Harrisburg, PA 17105-8016
Exception: The OIG 176-U and the OIG 176-SSI are not included with the OIG 173 referral.
A copy of the OIG 173 should be retained in the case record for six months from the referral date.
The CAO will contact the OSIG immediately by telephone at 1-717-787-6711 or 1-717-787-6694, when an individual calls or arrives at the CAO, reports receipt of personal property, and retains money to pay the claim. The individual should not be directed to call the OSIG.
The CAO will provide the OSIG with the following information: Payment name, claimant’s name, address, and telephone number, county, record number, category, type of personal property, due date/entitlement date, date received, and amount received.
The OSIG will determine whether the TPL-Casualty Unit in BFO or the OSIG is responsible for collecting the claim. If collection is an OSIG responsibility, the OSIG will compute and send a statement of claim to the individual within one workday. The OSIG also will send a copy of the statement of claim to the CAO. The individual will be instructed to mail the payment to the OSIG. The CAO will accept the payment if the individual brings it to the CAO. See Section 915.7, “Payment on a Reimbursement Claim.”
The OSIG will notify the TPL-Casualty Unit in BFO of the statement of claim request if the OSIG determines that collection is a TPL-Casualty Unit responsibility. The TPL-Casualty Unit will send a statement of claim to the individual’s legal representative within 90 days.
NOTE: The individual should not be referred to the OSIG regional office or to the OSIG field agent to pay the claim.
The CAO may also exchange information with the OSIG by memorandum. The CAO will send a memorandum with any information the CAO receives on:
inquiries regarding a claim;
circumstances to be considered when settling a claim;
court actions;
any factors the CAO feels are valuable in settling a claim; or
questions on law, legal action, or local problems relating to reimbursement requirements.
Updated January 3, 2024, replacing March 14, 2019