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How to fill out the Form 28t online
Filling out the Form 28t online is a crucial step for users involved in workers' compensation cases in North Carolina. This guide provides clear instructions on how to successfully complete each section of the form, ensuring your claims process runs smoothly.
Follow the steps to accurately complete and submit the Form 28t.
- Press the ‘Get Form’ button to retrieve the form and open it for editing.
- Enter the employee's name in the designated field to identify the individual associated with the compensation claim.
- Fill in the employer's name and current address, including city, state, and zip code, to provide the necessary context for the compensation process.
- Provide the employee's home telephone number and the last four digits of their social security number to verify their identity.
- Fill out the employee’s date of birth to confirm their age, which may be relevant for compensation calculations.
- Indicate the employer’s federal employer identification number (FEIN) alongside relevant codes (employee code, carrier code, and carrier file) for accurate tracking.
- Complete the section regarding the dates: the date of injury, the date disability began, and the date compensation was/will be terminated to create a timeline of the case.
- Provide the date the employee returned to work and indicate whether they are earning the same or greater wages, or reduced wages, at the time of completion.
- If the employee has returned to work at reduced wages, indicate if they are entitled to compensation for partial disability by selecting 'yes' or 'no'.
- If applicable, enter the name of the new employer and provide their contact details to reflect any changes in employment.
- Ensure that the form is signed by the employer or carrier/administrator, including their title and the date of signing.
- Finally, ensure that the form is submitted to the appropriate addresses and that copies are sent to the employee and their attorney, if applicable.
- Once all fields have been accurately filled out, save the changes, and download or print the form for submission.
Complete your Form 28t online today to manage your workers' compensation case efficiently.
Related links form
Failing to submit Form 18 can lead to delayed processing of your workers' compensation claim. Without this essential form, you may miss out on receiving the benefits you are entitled to. It's crucial to manage all required documentation properly, including other related forms like Form 28t, to secure your benefits efficiently.
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