We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Labor Forms
  • North Carolina Labor Forms
  • Nc Form 28u 2002

Get Nc Form 28u 2002

The Use Of This Form Is Required Under The Provisions of The Workers' Compensation Act ( Employee’s Name Employer's Name Address Employer’s Address City ( State ) ( Home Telephone / Sex Telephone Number City State Zip City State Zip Insurance Carrier ) Work Telephone M F Social Security Number Zip ) Carrier's Address ( / Date of Birth ) ( Carrier's Telephone Number ) Fax Number SECTION A. EMPLOYEE: COMPLETE AND MAIL TO EMPLOYER AND CARRIER/ADMINISTRATOR, A.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the NC Form 28U online

This guide provides a comprehensive overview of how to effectively complete the NC Form 28U online. It walks users through the form’s components, ensuring that individuals, regardless of their legal experience, can confidently fill out this important document.

Follow the steps to complete the NC Form 28U.

  1. Press the ‘Get Form’ button to acquire the form and open it for editing.
  2. Begin filling in your personal details. Enter your name, Social Security number, and contact information including home and work telephone numbers. Ensure that you also provide your date of birth and address.
  3. In section A, indicate your employer's name and their address. Specify the dates of your trial return to work and the date of your injury. Clearly articulate the reasons you are no longer working in the space provided.
  4. Obtain a statement from your authorized treating physician confirming your inability to continue the trial return to work due to your injury. This statement must include the physician’s medical specialty, signature, printed name, and address.
  5. If your return to work was with the same employer from whom you received workers’ compensation, sign in the designated area and proceed to review.
  6. If your return to work was with a different employer, complete section B. Provide the name and address of your last employer and authorize them to share your work-related information with your prior employer and the carrier/administrator.
  7. Lastly, make sure to sign and date the form. After thoroughly reviewing all entered information for accuracy, save your changes.
  8. You can now download the completed form for your records, print it for mailing, or share it as necessary. Be sure to send a copy to your employer and the carrier/administrator, and mail the original to the Industrial Commission.

Complete your NC Form 28U online today to ensure your compensation process continues smoothly.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

Form 28U - Notice of Accident to Employer - NC.gov
SEND A COPY OF THIS FORM TO THE EMPLOYER AND CARRIER/ADMINISTRATOR FROM WHOM YOU WERE...
Learn more
North Carolina State Government WORKERS ' ...
This form is used to notify the NCIC of a claim and will be provided by the employer or...
Learn more
F5 KEB V1.72.indb
(NC-contact). No jumper required, when a sensor is not connected ... X2A.24...26 Form C...
Learn more

Related links form

Fay Servicing Borrower Assistance Form 2020 Schwans Order Form 5-26-11 Ng Liang Shing First Aid Kit Inspection Forms

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

To file for workers' comp in North Carolina, begin by notifying your employer of your injury. You should complete necessary forms, including the NC Form 28U, and submit them to the appropriate authorities. Ensuring accurate information is critical to avoid delays. Uslegalforms can provide you with templates to streamline your application process.

Workers' compensation in North Carolina covers injuries that occur in the course of employment. This includes physical injuries, occupational diseases, and even mental health conditions stemming from workplace incidents. To ensure eligibility, maintaining documentation of the injury is crucial. Resources from uslegalforms can help clarify what qualifies under NC guidelines.

Yes, in North Carolina, there are specific time limits on workers' compensation benefits. Generally, you can receive compensation for a maximum of 500 weeks for total disability. However, the exact duration can depend on the nature of your injury. To better understand these timelines, working with resources like uslegalforms is advantageous.

In North Carolina, you typically have two years from the date of the injury to file a workers' comp claim. Missing this deadline can jeopardize your chances of receiving benefits. Hence, it's essential to act promptly and ensure all necessary forms, including NC Form 28U, are completed on time. Consulting uslegalforms can help you meet these deadlines.

In North Carolina, employers must report a workers' comp claim within five days of receiving notice of the injury. This quick reporting helps both the employer and the injured employee access benefits sooner. Timeliness is essential, so ensure you’re aware of the reporting requirements. For comprehensive guidance, uslegalforms has valuable resources.

Form 18 is a critical document in North Carolina workers' compensation cases. It is used to notify the North Carolina Industrial Commission about your injury and the circumstances surrounding it. Completing this form accurately helps facilitate your claim process. If you need assistance, uslegalforms offers templates to guide you through.

In North Carolina, employers are not legally obligated to hold your job while you're on workers' comp. However, certain federal protections, like the Family and Medical Leave Act, may apply. It's worthwhile to communicate with your employer about your situation. Seeking guidance through platforms like uslegalforms can clarify your rights.

In North Carolina, employees are generally protected from termination while on workers' comp. However, employers can terminate an employee for legitimate reasons unrelated to the claim, such as company policy violations. It's essential to understand your rights and document any communications regarding your employment status during this period. If unsure, consider consulting with a legal professional.

When visiting a workman's comp doctor, it's crucial to avoid downplaying your injuries or symptoms. Do not make statements that suggest your injuries are not as serious as they are. Additionally, avoid discussing any activities that contradict your claim. Clearly communicate your condition and any limitations you experience to ensure accurate assessment and treatment.

To file a workers' comp claim in North Carolina, begin by reporting your injury to your employer. Next, fill out the NC Form 28U to document the specifics of your injury. This form should be submitted to the employer's insurance company as soon as possible to initiate the claims process. Don't forget to keep a copy for yourself to track your claim.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get NC Form 28U
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
NC Form 28U
This form is available in several versions.
Select the version you need from the drop-down list below.
2017 NC Form 28U
Select form
  • 2017 NC Form 28U
  • 2016 NC Form 28U
  • 2002 NC Form 28U
Select form