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  • Vermont Dol Form 25

Get Vermont Dol Form 25

DOL FORM 25 State File No.** Ins. Co. File No. Date of Injury Fed. ID No. (Rev. 6/10) DEPARTMENT OF LABOR WORKERS' COMPENSATION DIVISION WAGE STATEMENT (Report of Employee's Wages) EMPLOYEE: EMPLOYER:.

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Workers' compensation insurance is mandatory for all Vermont employers. Most employers are aware of their coverage obligations and they know that it provides an injured worker with certain benefits.

Maximum rate is $1,542 and the minimum rate is $514 (not including dependent's benefits) for the year beginning July 1, 2021.

Vermont workers' compensation insurance can help: Pay for medical care if an employee gets hurt or sick from their job. Replace most of their lost wages if they miss work due to an injury or illness from their job. Pay for funeral costs if they lose their life due to a work accident or work-related illness.

In the Vermont workers' compensation system, permanent disability benefits are a type of benefit awarded to workers who have sustained such serious or debilitating injuries that they are left with lifelong impairment. This may prevent them from ever returning to regular, paid work.

$668.00 DETERMINATION: Therefore, the Commissioner determines the maximum weekly benefit amount as computed in ance with 21 V.S.A. § 1338 is $668.00 effective on or after July 3, 2022 and prior to July 2, 2023.

The short answer is that in Vermont, you do not have to pay tax on workers' compensation payments or personal injury settlements, but Social Security disability payments are taxed. Our attorneys explain below how an injury or disability payment could affect your tax return.

If your employer does not file a workers' compensation claim, then you can contact our office (802) 828-2286 and request a Form 5 – Employee's Notice of Injury and Claim for Compensation [PDF]. If you file a Form 5 you will be required to provide evidence that your injury was as a result of your employment.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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:
+1 833 426 79 33
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