FORMS
Employers are required to complete these two Industrial Commission Forms
What are Forms 19 & 22?
In NC, employers with this minimum number of employees must carry WC coverage.
What is three?
Under this statute, compensation is barred if an injury is proximately caused by a condition involving drugs or alcohol.
What is 97-12?
A penalty of this percentage is added when indemnity compensation is not paid when due.
What is 10%?
The first seven days of disability is called this.
What is the waiting period?
This Form is generally used to pay Permanent Partial Disability.
What is Form 26A?
What is the Industrial Commission?
Occupational diseases are listed in this statute.
What is 97-53?
Plaintiff attorney fees are commonly capped at this percentage.
What is 25%?
This body part has the highest scheduled weekly value for a PPD rating.
What is the Back?
An employee files this Form for travel reimbursement.
What is Form 25T?
The statute of limitations to file a claim is generally this long from the date of injury.
What is 2 years?
What is 97-31?
A fee in this amount may be due if Forms 60, 61, or 63 are not timely filed.
What is $400?
This Rule requires medical and employment records to be exchanged between parties.
What is Rule 607?
This Form is used to fully accept compensability of a claim.
What is Form 60?
Who is the employer?
Rights and remedies against third parties are contained in this statute.
What is 97-10.2?
The Commission receives a fee in this amount for mediated cases?
What is $200?
Number of roundtrip miles to medical appointments to be eligible for travel reimbursement.
What is 20?
This Form is used to report final payments for a claim that has not been settled.
What is Form 28B?
TTD benefits are paid at this percentage of an employee's average weekly wage?
What is 66 2/3%?
This statute is a catch-all for general definitions under the Act.
What is 97-2?
Employers who fail to secure WC coverage may face penalties for each of these noncompliance periods?
What is per day?
This Rule list the requirements of a compromise settlement agreement.
What is Rule 502?