Form HS-36-A. Ark. Code Ann. 11-. 14-101 & AWCC. Rule 36. Rev. 7-1-2010. ARKANSAS WORKERS' COMPENSATION COMMISSION. HEALTH & SAFETY .
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How to fill out the Form HS-36-A - Arkansas Workers' Compensation Commission - Awcc State Ar online
This guide provides a comprehensive overview of the Form HS-36-A used for the Arkansas Workers' Compensation Commission's Voluntary Drug-Free Workplace Program. It will assist users in effectively completing the form online, ensuring all required information is accurately provided.
Follow the steps to successfully complete the form online.
- Press the ‘Get Form’ button to access the form and open it for editing.
- Enter the company information. Fill in the company name, address (including city, state, and zip code), FEIN, and NAICS.
- Provide the effective date of your drug-testing program and the company contact's information, including their telephone number, title, and email.
- Specify the workers’ compensation insurance status, selecting either ‘Self-insured’ or ‘Purchase (WCI)’. Then, include the insurance carrier or third-party administrator details.
- Indicate the average number of employees during the last calendar year by entering the full-time and part-time figures.
- For the drug testing program, input the Program Manager or Third Party Administrator's information, including name, address, city, state, zip, telephone number, and email.
- Enter the testing lab's details: name, address, city, state, zip, telephone number, and lab certification number (only one certification is necessary).
- Attach a recent year-end summary report from your testing laboratory or a letter explaining why no tests were performed.
- Complete the employer certification section by signing and dating the form to affirm that the provided information is true and accurate.
- Notarize the form as required, then save your changes, download or print the completed form for submission.
Complete your document online to ensure compliance with the Arkansas Workers' Compensation requirements.
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How do I file a workers comp claim in Arkansas?
How to File a Workers' Compensation Claim in Arkansas Step 1: Notify Your Employer. ... Step 2: Try Resolving the Dispute Prior to Filing Forms. ... Step 3: Find the Correct Forms & Fill Them Out. ... Step 4: File and Serve Forms. ... Step 5: Attend All Mediation, Settlement Discussions, and Hearings. ... Step 6: Filing an Appeal.
How much does workers comp pay in Arkansas?
Percentage of Wages: Weekly wage benefits are tax-free and equate to 66 2/3 of your average weekly wage subject to a maximum rate. Maximum Rate: Weekly wage benefits are subject to a maximum of $835.00 for Total Disability (TD) and $626.00 for Permanent Partial Disability (PPD) as of Jan. 1, 2023.
Who is exempt from workers comp in Arkansas?
Businesses where there are two or fewer employees may not be covered. Railroad and maritime workers are covered by federal laws. The Arkansas Workers' Compensation Law does not apply to employment of agricultural farm labor, domestic help, or employment by non-profit, religious, charitable or relief organizations.
How does workers comp work in Arkansas?
Workers' compensation coverage is paid by your employer at no cost to you. It is your responsibility to report a work-related accident as soon as it happens. This coverage will pay for reasonably necessary medical care you need if you get hurt or get sick because of an injury on your job.
Is workers comp mandatory in Arkansas?
Arkansas Workers' Compensation Commission. Insurance Requirements: Most employers in Arkansas with three or more employees are required by law to have Workers' Compensation insurance coverage for their employees.
What is the Arkansas workers Compensation Commission?
The Arkansas Workers' Compensation Commission (WCC) enforces the workers' compensation law to ensure that all covered employer's secure insurance coverage from commercial carriers or through self- insurance programs.
Do I have to carry workers comp insurance in Arkansas?
Arkansas Workers' Compensation Commission. Insurance Requirements: Most employers in Arkansas with three or more employees are required by law to have Workers' Compensation insurance coverage for their employees.
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