Get Wc243 Form

The Wc243 Form is essential for employers seeking credit or reimbursement under O.C.G.A. § 34-9-243. This guide will provide clear, step-by-step instructions to assist users in completing the form online, ensuring accuracy and compliance with the requirements.

Follow the steps to fill out the Wc243 Form online effectively.

1. Click ‘Get Form’ button to access the Wc243 Form and open it in your preferred editor.
2. Begin with Section A, where you need to provide identifying information. Fill in the board claim number, last name, first name, middle initial, and the social security number of the employee. Additionally, include the date of the injury and specify the county where the injury occurred.
3. Continue in Section A by entering the employee's address, including the city, state, and zip code. Then, provide the employer's name and address. Make sure to also complete the insurer or self-insurer information, including contact details.
4. In Section B, which deals with credit requested, specify the type of credit being requested for benefits related to unemployment compensation, wage continuation plans, disability plans, or disability insurance policies by marking the relevant options.
5. Indicate the amount of weekly benefits paid to the employee and the date range for which the credit is sought. Provide the weekly amount and the starting date, ensuring accuracy as this information is crucial.
6. Calculate the ratio of the employer’s contributions to the total contributions and include that information along with the weekly credit amount that should be credited against TTD or TPD benefits due.
7. Finally, complete Section C by certifying that the information provided is true and correct. Include your printed name, signature, phone number, and email address, along with the date of completion.
8. Once all sections are filled, save any changes made to the form. You can then download, print, or share the completed Wc243 Form as necessary.

Start filling out the Wc243 Form online today for efficient processing.