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Oklahoma Prior Claims Request Prior Claims Request By Mail- Nonexempt Requestor

State:
Oklahoma
Control #:
OK-SKU-0828
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PDF
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Prior Claims Request Prior Claims Request By Mail- Nonexempt Requestor

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FAQ

When you are injured on the job and you are unable to work for more than 7 calendar days, you are eligible for weekly benefits amounting to 70% of your average weekly wage, up to the maximum set by law. The maximum is equal to the state's average weekly wage.

Form 2 Employer's First Report of Injury. As soon as you have been notified of a work-related injury, please fill out this form and provide the original to the Workers' Compensation Court and a copy to EMPLOYERS.

The Form 43 is to be completed by the respondent (employer/workers' compensation insurance carrier) to notify the Administrative Law Judge, the claimant (employee/decedent), and all parties to the claim of its intention to deny the compensability of all or part of the claimant's claim to workers' compensation benefits.

Claims forms are on the Commission's website, .wcc.ok.gov. They also are available at both Commission locations, 1915 N. Stiles Avenue, Oklahoma City, OK 73105 and 210 Kerr State Office Building, 440 S. Houston, Tulsa, OK 74127.

Consider contacting your insurance company to make a First Report of Injury before you file a claim via CC-Form 3. (All Forms submitted to the Commission shall be in black print on white paper. Please do not use colored forms.)

Workers' compensation claims files and their contents are kept for 25 years if a death claim, or for 10 years for all other claims, and then destroyed as provided by law. The records are destroyed annually based on the disposition schedule.

More info

Please complete this form and return it to the following address, together with all appropriate documents and a preaddressed stamped envelope. If a requestor asks for a summary of applicable charges before any copies are made, an agency must provide it.Federal Employees Program. OWCP's Federal Employees Program has made a variety of forms available online. Prior to responding to your request, the agency will review the records to make disclosure decisions. A variety of records is available on the Intercity Transit website. Request for Workers' Compensation. Be redacted, prior to the Central Coordinator finalizing and providing responsive documents. 9. Received the records under a previous request? Check box if request is a written confirmation of a prior oral request.

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Oklahoma Prior Claims Request Prior Claims Request By Mail- Nonexempt Requestor