Get Video Dawnload

This guide provides detailed instructions for effectively completing the Video Dawnload form online. Whether you are an employer or an individual seeking support, these step-by-step guidelines will help ensure accuracy and streamline the process.

Follow the steps to fill out the Video Dawnload form with ease.

1. Click the ‘Get Form’ button to access the form. It will enable you to open the necessary document in your preferred editing tool.
2. Begin by entering the claim number at the top of the form. This number is crucial for linking your submission to the correct case.
3. Fill in the injured worker's name and the employer's name accurately. Ensure you double-check spelling to prevent any processing delays.
4. Provide the telephone number of the employer. This contact information should be current to facilitate communication regarding the claim.
5. If applying for Wage Loss benefits, indicate the FROM and TO dates corresponding to the period of wage loss.
6. For employees who were continuously employed for seven days prior to the date of injury, complete questions 1 and 2. For those employed less than seven days, answer questions 3 and 4.
7. Input the total gross wages earned in the six weeks leading up to the injury, including any overtime pay, in the designated field.
8. Record the total gross wages for the first seven days prior to the injury while excluding overtime.
9. State the employee's hourly rate of pay for the week in which the injury occurred.
10. Indicate the number of hours the employee was scheduled to work during the week of the injury.
11. Utilize the worksheet provided to report the employee's weekly wage across the year prior to the injury, ensuring no deductions are made. Include any reasons for periods not worked.
12. If the employee received additional benefits such as meals or lodging, describe these and state their weekly value.
13. Answer the question regarding whether the employee will receive any wages, benefits, or other compensations during their disability period. Provide details if applicable.
14. After all fields are completed, review the information for accuracy before signing the form as the employer.
15. Finally, save your changes, download the filled form, print it, or share it as needed.

Complete your Video Dawnload form online today for a smooth processing experience.