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Get Ga Wc-102b 2011-2025
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How to fill out the GA WC-102b online
Filling out the GA WC-102b form is an important step for attorneys representing parties other than a claimant or employee in workers' compensation cases in Georgia. This guide offers clear, step-by-step instructions to ensure that users can complete the form accurately and effectively.
Follow the steps to successfully complete the GA WC-102b form online.
- Click ‘Get Form’ button to begin the process and open the form in your editor.
- Enter the board claim number in the designated field. This number is essential for identifying the claim related to this notice.
- Provide the employee’s last name, first name, and middle initial in the appropriate fields to ensure correct identification.
- Fill in the date of injury, as well as the employee’s Social Security Number (SSN) or board tracking number if applicable.
- In section A, include identifying information such as the county of injury and the employee’s address, including city, state, and zip code.
- Enter the attorney's information, including their name, address, city, state, zip code, and Georgia Bar number in the designated fields.
- Complete the employer's details, providing name, address, city, state, and zip code.
- Fill in the information for the insurer or self-insurer, including name and address.
- Specify the party at interest and claims office in the respective sections, ensuring to include their full addresses and email addresses.
- In section B, fill out the attorney's information, which includes their firm’s name, mailing address, phone number, and email address.
- In section C, provide the attorney’s signature, along with their email address and the date to certify that the information is accurate.
- Review the completed form for accuracy and completeness before submitting. You can save changes, download, print, or share the form as needed.
Complete your workers' compensation documents online today for an efficient submission process.
To locate your workers' comp claim number, follow up with your employer or their insurance provider through a direct inquiry. They can assist you in retrieving this number. Additionally, your GA WC-102b should reference your claim if you have filed it, helping you keep your records in order.
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