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  • 1. Arkansas First Report Of Injury Or Illness- Form Ia-1- Arkansas ...

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Jan 1, 2001 ... Welcome to the Workers Compensation Insurance Program offered through Tower Group ... 1.1.2001) This form is to be completed by the employer if the claimant receives less ... EMPLOYER.

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If you don't report your injury within 30 days, you could lose your right to receive workers' compensation benefits.

Once your employer is notified, they should report the injury to their insurance carrier. You will probably be required to complete additional paperwork and see an approved doctor. Under Arkansas law, a workers' compensation claim must be filed within two years of the accident date.

Percentage of Wages: Weekly wage benefits are tax-free and equate to 66 2/3 of your average weekly wage subject to a maximum rate. Maximum Rate: Weekly wage benefits are subject to a maximum of $835.00 for Total Disability (TD) and $626.00 for Permanent Partial Disability (PPD) as of Jan. 1, 2023.

Arkansas' Second Injury Fund was established by Act 750 of 1973. Similar to other states, the Arkansas Second Injury Fund was created to encourage employment of disabled workers by limiting, in the event of a subsequent injury, the employer's liability for permanent disability benefits.

While you do have two years from the date of injury to file a claim with the Arkansas Workers' Compensation Commission, injured employees should not delay. Once you miss this deadline, you will be barred from asserting a claim for workers' compensation benefits.

Your employer will then fill out a “First Report of Injury” and submit this form to the Arkansas Workers' Compensation Commission, as well as the insurance company. If you fail to notify your employer within 30 days, your claim could be ignored or denied altogether.

Form 1A-1 First Report of Injury (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed immediately upon notice of a work-related injury. Fatalities must be reported within 24 hours.

The Employer's Report of Occupational Injury or Illness (Form 5020). Every employer is required to file a complete report of every occupational injury or illness to each employee which results in lost time beyond the date of injury or illness or which requires medical treatment beyond first aid*.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232