Get Form Xix

Medicaid (Title XIX of the Social Security Act)​ The Medicaid program was authorized by Title XIX of the Social Security Act Amendments of 1965 (Public Law 89-97), which was signed into law by President Lyndon Johnson. Medicaid is a joint state-federal program.

Form 18. This is where you begin when you have a claim. This form MUST be filled out completely and submitted to the Industrial Commission when you have been injured on the job. (Note: Please e-mail completed forms to forms@ic.nc.gov.)

About the Central Wage Slip Form XIX It incorporates all details regarding the contractor and the workers like name, father's name, nature of work, location, and whether the central wage slip Form XIX is prepared for a week or a month.

Form 19 - This is the Report of Injury form to be completed by your employer. Form 18 - This is the Injured Worker Notice of Accident Claim form to be completed and filed with the Industrial Commission by you when you have been injured on the job.

This covers establishment as well as principal employer particulars with reference to wage cycle ( weekly, fortnightly,and monthly), nature of work, location of work, employee details, wage rate, overtime work particulars, gross wage, deductions, and actual wage paid.