This is one of the official workers' compensation forms for the the state of North Carolina
Workers Compensation In North Carolina Agreement With Work
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How to fill out North Carolina Agreement For Compensation For Workers' Compensation?
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FAQ
Benefits for lost wages will only begin seven days after the date of the injury, and you will receive payment for the first seven days of missed work only if you are off work 21 days or more.
North Carolina Industrial Commission (NCIC) Form 33 is the Request That Claim Be Assigned for Hearing. This form is used when the two parties, the injured employee and the employer/insurance company, cannot come to an agreement on compensation for the injuries the employee sustained and require a formal hearing.
Workers' Comp laws in NC provide injured workers medical treatment for their injuries as well as wage replacement when they are disabled. Unlike the tort/negligence system which allows recovery for pain and suffering NC workers' compensation laws provide coverage primarily for economic losses.
Those businesses that employ three or more employees are required to carry workers compensation insurance except agricultural employment with fewer than 10 employees, certain sawmill and logging operations and all domestic employees are exempt.
North Carolina law specifies that any business that employs three or more people is required to carry workers' compensation coverage. This policy provides medical benefits in the event of a work-related accident.