This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Recipient's Name] [Recipient's Designation] [Workers Compensation Commission] [Address] [City, State, ZIP Code] Subject: Request for Issuance of Subpoena in Workers Compensation Case — [Claimant's Name and Case Number] Dear [Recipient's Name], I hope this letter finds you well. I am writing to formally request the issuance of a subpoena in connection with a workers' compensation case currently pending before the commission. I represent [Claimant's Name], who was injured while performing their duties at their workplace [provide details of the incident]. As part of our efforts to gather evidence and establish liability on behalf of our client, it is crucial to obtain certain records, documents, and witness testimony that we believe will be instrumental in strengthening our case. We are requesting the commission's assistance in issuing a subpoena to the following entities: 1. [Name of Medical Provider(s)]: We seek medical records, diagnostic reports, and any other relevant documentation regarding the treatment, diagnosis, and prognosis of our client's injuries sustained in the workplace accident. 2. [Name(s) of Employer or Company Representative(s)]: We request the commission to subpoena the company's representative(s) who possess knowledge of the incident or its aftermath. Witness testimony from these individuals may provide valuable insight into the conditions leading to the accident and the subsequent response of the employer. 3. [Name(s) of Insurance Company(IES)]: We require the production of any insurance policies related to workers compensation coverage for our client. This will enable us to determine the scope of available benefits and ensure proper compensation is provided. 4. [Name(s) of Co-Worker(s) or Eye Witness(BS)]: We would like to obtain statements and testimonials from individuals who may have witnessed the accident or have relevant information concerning the incident. We kindly request that the issued subpoena(s) be delivered to our firm's address mentioned above or directly to the designated representative we will provide to you promptly. If there are any fees associated with this request, please inform us in advance, and we will arrange payment accordingly. Your cooperation in facilitating the issuance of the requested subpoenas would significantly contribute to the efficiency and fairness of the proceedings. We are confident that obtaining these documents and testimonies will facilitate an accurate determination of our client's entitlement to compensation. Thank you for your prompt attention to this matter. We appreciate your assistance in ensuring a fair and just resolution to these workers' compensation case. Please do not hesitate to contact me if you require any further information or clarification. Sincerely, [Your Name] [Your Firm's Name] [Your Firm's Address] [City, State, ZIP Code] [Email Address] [Phone Number] Keywords: Georgia, sample letter, workers compensation commission, issuance of subpoena, workers compensation case, claimant, evidence, liability, medical records, diagnostic reports, witness testimony, insurance policies, co-workers, eye-witnesses.
[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Recipient's Name] [Recipient's Designation] [Workers Compensation Commission] [Address] [City, State, ZIP Code] Subject: Request for Issuance of Subpoena in Workers Compensation Case — [Claimant's Name and Case Number] Dear [Recipient's Name], I hope this letter finds you well. I am writing to formally request the issuance of a subpoena in connection with a workers' compensation case currently pending before the commission. I represent [Claimant's Name], who was injured while performing their duties at their workplace [provide details of the incident]. As part of our efforts to gather evidence and establish liability on behalf of our client, it is crucial to obtain certain records, documents, and witness testimony that we believe will be instrumental in strengthening our case. We are requesting the commission's assistance in issuing a subpoena to the following entities: 1. [Name of Medical Provider(s)]: We seek medical records, diagnostic reports, and any other relevant documentation regarding the treatment, diagnosis, and prognosis of our client's injuries sustained in the workplace accident. 2. [Name(s) of Employer or Company Representative(s)]: We request the commission to subpoena the company's representative(s) who possess knowledge of the incident or its aftermath. Witness testimony from these individuals may provide valuable insight into the conditions leading to the accident and the subsequent response of the employer. 3. [Name(s) of Insurance Company(IES)]: We require the production of any insurance policies related to workers compensation coverage for our client. This will enable us to determine the scope of available benefits and ensure proper compensation is provided. 4. [Name(s) of Co-Worker(s) or Eye Witness(BS)]: We would like to obtain statements and testimonials from individuals who may have witnessed the accident or have relevant information concerning the incident. We kindly request that the issued subpoena(s) be delivered to our firm's address mentioned above or directly to the designated representative we will provide to you promptly. If there are any fees associated with this request, please inform us in advance, and we will arrange payment accordingly. Your cooperation in facilitating the issuance of the requested subpoenas would significantly contribute to the efficiency and fairness of the proceedings. We are confident that obtaining these documents and testimonies will facilitate an accurate determination of our client's entitlement to compensation. Thank you for your prompt attention to this matter. We appreciate your assistance in ensuring a fair and just resolution to these workers' compensation case. Please do not hesitate to contact me if you require any further information or clarification. Sincerely, [Your Name] [Your Firm's Name] [Your Firm's Address] [City, State, ZIP Code] [Email Address] [Phone Number] Keywords: Georgia, sample letter, workers compensation commission, issuance of subpoena, workers compensation case, claimant, evidence, liability, medical records, diagnostic reports, witness testimony, insurance policies, co-workers, eye-witnesses.