The New Hampshire Wage and Income Loss Statement, also known as the NH Wage and Income Loss Affidavit, is a legal document used to determine an individual's potential wage and income loss due to a personal injury, disability, or other circumstances. This statement plays a vital role in many legal proceedings and insurance claims to calculate the appropriate compensation for the affected individual. The New Hampshire Wage and Income Loss Statement is divided into different types based on the purpose it serves. Some common types include: 1. Personal Injury Wage and Income Loss Statement: This type of statement is typically used in personal injury cases where an individual has suffered harm due to someone else's negligence. It helps determine the financial impact of the injury by analyzing the injured person's pre-accident earnings, potential future earnings, and any income loss incurred as a result of the injury. 2. Workers' Compensation Wage and Income Loss Statement: This statement is specific to workers' compensation claims in New Hampshire. It is required to determine the extent of wage and income loss suffered by an employee due to a work-related injury or illness. It includes details of the employee's average weekly wages, reduced earning capacity, and other relevant factors to calculate the appropriate compensation. 3. Social Security Disability Income Loss Statement: This type of statement is used in cases where individuals are seeking Social Security Disability benefits due to a physical or mental impairment that prevents them from engaging in substantial gainful activity. The statement helps establish the extent of the income loss caused by the disability and assists in determining the disability benefits. When preparing a New Hampshire Wage and Income Loss Statement, it is important to provide accurate and detailed information to ensure a fair assessment of the financial impact caused by the underlying circumstances. Key information typically included in this statement includes the individual's employment history, average earnings, work capacity post-incident, any work-related restrictions or limitations, medical documentation, and other relevant supporting evidence. Ultimately, the New Hampshire Wage and Income Loss Statement is a crucial document that helps quantify the economic impact suffered by individuals in various legal and insurance contexts, allowing for appropriate compensation to be awarded.