Get Instructions For Completing Attached Hearing Application (form Wkc-7)

Completing the Instructions For Completing Attached Hearing Application (form Wkc-7) online can be a straightforward process with the right guidance. This user-friendly guide will help you navigate through each section of the form to ensure that your application is filled out accurately and submitted without delays.

Follow the steps to properly complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the employee information section (Boxes 1 - 1E, 2C - 2D, 3B - 3D, and 4 - 4C), provide detailed information about the injured or deceased worker. Ensure that the correct Social Security Number and a complete address are included. If you are claiming death benefits, remember that 'EMPLOYEE' in Box 1 refers to the person seeking the hearing.
3. For the employer information (Boxes 2 - 2B), complete the employer’s address and telephone number in Box 2, and describe the nature of the employer's business in Box 2A.
4. In Boxes 3 - 3A, list the name of the employer's worker's compensation insurance carrier or self-insured employer relevant to the date of injury, if known.
5. For Boxes 3B - 3D, document all dates related to the injury and the notification given to the employer. If there are multiple injuries or employers, attach additional sheets as needed.
6. In Box 5, clearly describe the nature of the injury or death, including the body parts affected and the exact location where the incident occurred.
7. Provide additional disability information in Boxes 6A - 6G as required, incorporating relevant dates and figures.
8. In Box 7, list all healthcare providers consulted regarding the injury. If more space is needed, attach a separate sheet.
9. In Box 14, sign and date the application. If you have an attorney, review the attorney’s fee statement and mark the appropriate option in the box.
10. Review all the sections you have completed to ensure accuracy. Finally, save any changes you have made, and choose to download, print, or share the completed form as needed.

Start completing your hearing application online today to ensure your claim is properly filed.