Some state worker's compensation acts also provide that a formal claim for compensation be made, either to the employer, the compensation board, or to the state commission board with notice to the employer that the claim is being made. This claim or notice of claim is different from the notice of injury and is governed by a different, and sometimes longer, statute of limitations. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Charlotte North Carolina Notice of Work-Related Injury and Claim for Worker's Compensation
Category:
State:
Multi-State
City:
Charlotte
Control #:
US-01495BG
Format:
Word;
Rich Text
Instant download
This website is not affiliated with any governmental entity
Public form
