Vermont Workers Compensation Questionnaire

State:
Multi-State
Control #:
US-Q1038
Format:
Word; 
Rich Text
Instant download

Description

This form addresses important matters that may effect the legal rights and obligations of the parties in a workers' compensation matter. This questionnaire enables those seeking legal help to effectively identify and prepare their issues and problems. Thorough advance preparation enhances the attorney’s case evaluation and can significantly reduce costs associated with case preparation.



This questionnaire may also be used by an attorney as an important information gathering and issue identification tool when forming an attorney-client relationship with a new client. This form helps ensure thorough case preparation and effective evaluation of a new client’s needs. It may be used by an attorney or new client to save on attorney fees related to initial interviews.


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FAQ

The insurance company must ?accept? or ?deny? your claim within 21 days of the injury by filing a Form 2 with the Department of Labor. If you are not sure if your claim was accepted or denied, call the Vermont Department of Labor at (802) 828-2286.

Vermont Workers' Compensation Requirements Sole-Proprietors and Partners are excluded from coverage automatically, but may elect to be exempt. Corporate Officers and LLC Members are automatically included in coverage, but they may elect to be excluded.

Vermont workers' compensation insurance can help: Pay for medical care if an employee gets hurt or sick from their job. Replace most of their lost wages if they miss work due to an injury or illness from their job. Pay for funeral costs if they lose their life due to a work accident or work-related illness.

day ?waiting period? is applied to WC disability payments. If an employee is disabled for four to ten consecutive days, payment is calculated starting from the fourth day of disability. If disability extends beyond ten days, payment is calculated from the first day of disability.

Vermont Rates for Select Work Comp Class Codes Class Code & DescriptionLow RateHigh Rate8742 Sales Professional$0.41$0.588810 Clerical-Office Employee$0.15$0.218824 Retirement Living Centers-Congregate Communities$3.28$4.668824* Nursing Homes & Assisted Living Facilities$3.28$4.6663 more rows

21 Days calculating in case of FORM 5 If an Employee's Notice of Injury and Claim for Compensation (Form 5) is filed by an injured worker, the employer/carrier shall investigate the claim immediately to determine whether any compensation is due within 21 days.

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Vermont Workers Compensation Questionnaire