This is one of the official workers' compensation forms for the the state of North Carolina
Workers Comp North Carolina Agreement Form
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Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
HOW DO YOU CALCULATE WHAT AN INJURY RATING IS WORTH? It is usually simple to calculate how much an injury rating is worth. Just multiply the injury percentage rating by the employee's compensation rate, and then multiply that result by the number of weeks assigned to the injured body part.
What does a Form 18 do? A Form 18 establishes a legal claim of injury on your behalf if filed within two years of the date of injury or occupational disease, and gives the required written notice to the employer if a copy is submitted to the employer within 30 days of the injury.
Your employer is required to report an injury to their Workers' Compensation insurance carrier for an injury sustained in the course of employment where the attention of a physician is needed or actually sought.
To date, the largest settlement payment in a workers' comp case came in March of 2017, with a $10 million settlement agreement.
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.
