Get Petition For Trial Form - Workers' Compensation Court - Wcc Dli Mt

This guide provides detailed instructions on completing the PETITION FOR TRIAL FORM for the Workers' Compensation Court in Montana. By following these steps, users can efficiently navigate the form online and ensure that all necessary information is included.

Follow the steps to complete the petition form online.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Fill in your personal information, including your name, address, and phone number at the top of the form. Ensure accuracy in entering your details to avoid any discrepancies.
3. In the petitioner section, enter the name of the organization or individual you are filing against as the respondent or insurer.
4. Provide the Workers' Compensation Court case number (if applicable) next to 'WCC No.'
5. Complete section 1 by indicating the date you became aware of the occupational disease. Specify where the disease arose during the course of your employment, including the name of the employer and the county.
6. Describe the occupational disease in detail, including its origins from your employment.
7. In section 2, ensure to provide the compensation plan number of your employer and the name of the insurance provider.
8. Detail the nature of the dispute between the parties in section 3. If more space is needed, attach additional pages.
9. Confirm that all pertinent medical records have been exchanged with the respondent as stated in section 4.
10. In section 5, select the appropriate paragraph regarding the resolution of the dispute by checking the box that applies.
11. List potential witnesses and their addresses in section 6, including the general subject matter of their testimony.
12. In section 7, include a list of written documents that will be introduced as evidence in your case.
13. Clearly outline the relief you are seeking from the Court at the end of the petition, detailing what decisions you wish the Court to make.
14. Date the form and sign it where indicated.
15. Once you have completed filling out the form, you can save changes, download, print, or share the form as needed.

Complete your PETITION FOR TRIAL FORM online to ensure a smooth filing process.