Get Order For Judgment Order Approving Settlement ...

Filling out the order for judgment order approving settlement is a crucial step in the workers’ compensation process. This guide will provide clear instructions to help users accurately complete the form online, ensuring a smooth submission experience.

Follow the steps to fill out the order for judgment order approving settlement.

1. Click the ‘Get Form’ button to obtain the form and open it in your editor.
2. Begin by entering the petitioner's name and address in the designated fields. This information is essential for identifying the individual involved in the case.
3. Fill in the date of birth and indicate whether the petitioner is Medicare eligible by selecting 'yes' or 'no'.
4. Provide the respondent's name, insurance carrier details, and attorney’s name in the respective sections.
5. Input the case number and the federal employer number, which are crucial for tracking the case.
6. Describe the accident or occupational exposure in brief, including the date, to provide context for the settlement.
7. List any administrative dismissals by naming other insurance carriers involved in the case.
8. Complete the sections for weekly wages and any rates that apply to the settlement.
9. If this is a re-opened petition, indicate the relevant prior award date and amount in the specified section.
10. Review the order for judgment section ensuring it reflects that the petitioner is awarded compensation benefits as outlined.
11. In the order approving settlement section, confirm that you agree with the terms and that the settlement is deemed fair.
12. Indicate any medical bills or additional fees that should be considered, and ensure all financial amounts are correctly calculated.
13. Finally, save your changes, and choose to download, print, or share the completed form as necessary.

Complete your documents online today to ensure a timely and accurate submission.