Get Nc Form 28u 2020-2025

Filling out the NC Form 28U is essential for individuals seeking to have their workers' compensation reinstated following an unsuccessful trial return to work. This guide provides clear instructions on completing the form efficiently and accurately online.

Follow the steps to complete the NC Form 28U online:

1. Click the ‘Get Form’ button to access the NC Form 28U and open it in your preferred online editor.
2. In the first section, input your full name, along with your employee code and carrier code. This information is crucial for identifying your case.
3. Provide your employer's name and address, including city, state, and zip code. Ensure all information is accurate to facilitate communication.
4. Next, enter your home telephone number, the last four digits of your social security number, sex, and your work telephone number.
5. In the section labeled 'Employee', state your request clearly by writing that you want your total disability compensation to resume immediately. Include the name of your employer, your trial return to work dates, and the date of your injury or disability.
6. Provide a detailed explanation outlining the reasons for your inability to continue working during the trial return. This information helps clarify your situation.
7. You must obtain a statement from your authorized treating physician confirming your inability to work due to your injury. This statement should include the physician’s signature, printed name, address, city, state, and zip code.
8. If your return to work was with the employer from whom you received workers' compensation, sign and date the form here and avoid filling out Section B. If not, proceed to complete Section B.
9. In Section B, authorize your last employer to release information regarding your trial return to work to your prior employer and carrier/administrator by providing their name and address.
10. Sign and date Section B to finalize your authorization.
11. Once all sections are completed, review the form for accuracy. You can save any changes, download a copy, print it, or choose to share it as needed.

Complete your documentation online today to ensure a smooth process for your workers' compensation request.