North Carolina Notification of Workers' Compensation Injury - Illness

• Category: Employment - Health and Safety
• State: Multi-State
• Control #: US-294EM
• Format: Word; Rich Text

Description

This form is used to inform a worker's compensation firm of an injury or illness of sustained by an employee while on duty. The North Carolina Notification of Workers' Compensation Injury — Illness is a legal document that serves as a formal report to notify the employer and the North Carolina Industrial Commission (CIC) of a workplace injury or illness. This notification is crucial for initiating the workers' compensation process, ensuring that injured employees receive proper benefits and medical care. Keywords: North Carolina, notification, Workers' Compensation, injury, illness, employer, Industrial Commission, benefits, medical care. There are different types of North Carolina Notification of Workers' Compensation Injury — Illness forms, each designed for specific circumstances: 1. Form 19 — Employer's Report of Employee's Injury or Occupational Disease: This form is completed by the employer to report an employee's injury, illness, or occupational disease to the CIC. It includes details such as date, time, location, cause of the incident, and a description of the injury or illness. 2. Form 19A — Supplemental Report of Employer or Carrier: This form is used when additional information is needed to supplement the initial report filed on Form 19. It may include updates on the employee's medical condition, treatment progress, or any changes in the employee's status. 3. Form 18M — Request that Medical Compensation Formal Hearing Be Held Before Deputy Commissioner: This form is filed by an injured employee requesting a formal hearing before a Deputy Commissioner to resolve disputes related to medical compensation. It outlines the nature of the dispute, the requested relief, and any supporting evidence. 4. Form 22 — Employee's Notice of Accident: This form is completed by the injured employee to notify their employer of an accident or occupational disease resulting in injury or illness. It includes information such as the date, time, and location of the incident, as well as a description of the injuries sustained. 5. Form 25 N—- Report of First Physician: This form is filled out by the attending physician responsible for an injured employee's initial treatment. It provides details on the diagnosis, treatment plan, and expected duration of disability. 6. Form 25P — Report of Subsequent Treatment or Examination: This form is used by the treating physician to update the CIC on any subsequent treatments, examinations, or changes in the employee's medical condition after an initial report has been filed. It is essential for both employers and employees in North Carolina to familiarize themselves with these different Notification of Workers' Compensation Injury — Illness forms. Filing the appropriate form accurately and promptly ensures compliance with state regulations and helps protect the rights and benefits of injured workers.

The North Carolina Notification of Workers' Compensation Injury — Illness is a legal document that serves as a formal report to notify the employer and the North Carolina Industrial Commission (CIC) of a workplace injury or illness. This notification is crucial for initiating the workers' compensation process, ensuring that injured employees receive proper benefits and medical care. Keywords: North Carolina, notification, Workers' Compensation, injury, illness, employer, Industrial Commission, benefits, medical care. There are different types of North Carolina Notification of Workers' Compensation Injury — Illness forms, each designed for specific circumstances: 1. Form 19 — Employer's Report of Employee's Injury or Occupational Disease: This form is completed by the employer to report an employee's injury, illness, or occupational disease to the CIC. It includes details such as date, time, location, cause of the incident, and a description of the injury or illness. 2. Form 19A — Supplemental Report of Employer or Carrier: This form is used when additional information is needed to supplement the initial report filed on Form 19. It may include updates on the employee's medical condition, treatment progress, or any changes in the employee's status. 3. Form 18M — Request that Medical Compensation Formal Hearing Be Held Before Deputy Commissioner: This form is filed by an injured employee requesting a formal hearing before a Deputy Commissioner to resolve disputes related to medical compensation. It outlines the nature of the dispute, the requested relief, and any supporting evidence. 4. Form 22 — Employee's Notice of Accident: This form is completed by the injured employee to notify their employer of an accident or occupational disease resulting in injury or illness. It includes information such as the date, time, and location of the incident, as well as a description of the injuries sustained. 5. Form 25 N—- Report of First Physician: This form is filled out by the attending physician responsible for an injured employee's initial treatment. It provides details on the diagnosis, treatment plan, and expected duration of disability. 6. Form 25P — Report of Subsequent Treatment or Examination: This form is used by the treating physician to update the CIC on any subsequent treatments, examinations, or changes in the employee's medical condition after an initial report has been filed. It is essential for both employers and employees in North Carolina to familiarize themselves with these different Notification of Workers' Compensation Injury — Illness forms. Filing the appropriate form accurately and promptly ensures compliance with state regulations and helps protect the rights and benefits of injured workers.