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  • Ri Dwc-04 2013

Get Ri Dwc-04 2013-2025

Employee 's Certificate of Dependency StatusCheck if this is a corrected reportState of Rhode Island Department of Labor and Training, Division of Workers ' Compensation PO Box 20190, Cranston, RI.

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Related content

complete this form and return it to the Claim...
State of Rhode Island ... PO Box 20190, Cranston, RI 02920-0942 Phone (401) 462-8100...
Learn more
DWC 04 DF - The University of Rhode Island
State of Rhode Island. PLEASE CHECK IF CORRECTION OF PRIOR ... DWC No. Phone (401)...
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HealthSmart Provider Manual
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Your employer should fill out the “employer” section and forward the completed claim form to the insurance company. You should receive a copy of the completed claim form from your employer. If you don't, request a copy and keep it for your records.

Yes, all RI employers with one or more employees are required to obtain workers' compensation insurance.

Division of Workers' Compensation (DWC)

DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers' compensation benefits and the Medical Provider Network (MPN) in California.

Total disability benefits last for as long as you are totally disabled, even if that is the rest of your life. Partial disability benefits can continue for up to six years.

Request an "Employee's Claim for Workers' Compensation Benefits" form from your supervisor (it's also known as a DWC 1 form). Your employer must give or mail you a claim form within one working day after learning about your injury or illness.

When you reach a point where your medical condition is not improving and not getting worse, your condition is called “permanent and stationary” (P&S). This is referred to as the point in time when you have reached maximal medical improvement (MMI). When this happens, your primary treating physician writes a P&S report.

Filling out a DWC-1 form is actually pretty straightforward....On the form, you will need to only fill out the “Employee” section, which asks for basic information: Name, date, and address. Date and location of injury. Brief description of injury. List of injured body parts. Social Security Number.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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