Contra Costa California Sample Letter to Workers Compensation Commission for Issuance of Subpoena

• Category: Letters - Legal - Subpoenas
• State: Multi-State
• County: Contra Costa
• Control #: US-0949LTR
• Format: Word; Rich Text

Description

This form is a sample letter in Word format covering the subject matter of the title of the form. [Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date] [Workers Compensation Commission] [Address] [City, State, Zip Code] Subject: Request for Issuance of Subpoena Dear [Workers Compensation Commission], I hope this letter finds you well. I am writing to request the issuance of a subpoena by the Workers Compensation Commission in relation to a Workers Compensation case currently under investigation. The details of the case are as follows: 1. Case Name: [Case Name] 2. Case Number: [Case Number] 3. Employer Name: [Employer Name] 4. Injured Worker: [Injured Worker Name] 5. Date of Injury: [Date of Injury] 6. Workers Compensation Insurance Carrier: [Insurance Carrier Name] We believe that certain evidence and documents are crucial to the fair resolution of this case. In order to gather the necessary information and protect the rights of the injured worker, we kindly request the issuance of the following subpoenas: 1. Medical Records Subpoena: — To [Medical Facility/Hospital Name— - Request for all medical records, including diagnoses, treatment plans, progress notes, radiology reports, and any other relevant documents related to the treatment of the injured worker since the date of the accident. 2. Employment Records Subpoena: — To [Employer Name— - Request for all employment records of the injured worker, including but not limited to hiring documents, time cards, wage statements, personnel files, and any other documents relevant to the case. 3. Witness Testimony Subpoena: — To [Witness Name/Company Name— - Request for the appearance and testimony of [Witness Name] to provide a statement regarding their knowledge of the accident or the injured worker's condition. 4. Surveillance Footage Subpoena: — To [Surveillance Footage Owner— - Request for all surveillance footage recordings from [Date of Injury] onwards that may have captured the incident or verify the extent of the injured worker's claimed injuries. By obtaining these documents and testimony, we believe we can effectively assess the legitimacy of the worker's compensation claim and facilitate fair resolution. We kindly request that the subpoenas be issued promptly to ensure the timely gathering of evidence. Please let us know if there are any fees associated with the issuance of these subpoenas, and we will promptly submit the required payment. Thank you for your attention to this matter. We look forward to your favorable response and the efficient processing of our request. If you require any additional information or documents, please do not hesitate to contact me at [your contact information]. Sincerely, [Your Name] [Your Title/Position] [Your Organization/Company Name]

[Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date] [Workers Compensation Commission] [Address] [City, State, Zip Code] Subject: Request for Issuance of Subpoena Dear [Workers Compensation Commission], I hope this letter finds you well. I am writing to request the issuance of a subpoena by the Workers Compensation Commission in relation to a Workers Compensation case currently under investigation. The details of the case are as follows: 1. Case Name: [Case Name] 2. Case Number: [Case Number] 3. Employer Name: [Employer Name] 4. Injured Worker: [Injured Worker Name] 5. Date of Injury: [Date of Injury] 6. Workers Compensation Insurance Carrier: [Insurance Carrier Name] We believe that certain evidence and documents are crucial to the fair resolution of this case. In order to gather the necessary information and protect the rights of the injured worker, we kindly request the issuance of the following subpoenas: 1. Medical Records Subpoena: — To [Medical Facility/Hospital Name— - Request for all medical records, including diagnoses, treatment plans, progress notes, radiology reports, and any other relevant documents related to the treatment of the injured worker since the date of the accident. 2. Employment Records Subpoena: — To [Employer Name— - Request for all employment records of the injured worker, including but not limited to hiring documents, time cards, wage statements, personnel files, and any other documents relevant to the case. 3. Witness Testimony Subpoena: — To [Witness Name/Company Name— - Request for the appearance and testimony of [Witness Name] to provide a statement regarding their knowledge of the accident or the injured worker's condition. 4. Surveillance Footage Subpoena: — To [Surveillance Footage Owner— - Request for all surveillance footage recordings from [Date of Injury] onwards that may have captured the incident or verify the extent of the injured worker's claimed injuries. By obtaining these documents and testimony, we believe we can effectively assess the legitimacy of the worker's compensation claim and facilitate fair resolution. We kindly request that the subpoenas be issued promptly to ensure the timely gathering of evidence. Please let us know if there are any fees associated with the issuance of these subpoenas, and we will promptly submit the required payment. Thank you for your attention to this matter. We look forward to your favorable response and the efficient processing of our request. If you require any additional information or documents, please do not hesitate to contact me at [your contact information]. Sincerely, [Your Name] [Your Title/Position] [Your Organization/Company Name]