Alaska Sample Letter for Client's Injuries and Diagnosis

State:
Multi-State
Control #:
US-0540LTR
Format:
Word; 
Rich Text
Instant download

Description

This form is a sample letter in Word format covering the subject matter of the title of the form.

How to fill out Sample Letter For Client's Injuries And Diagnosis?

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FAQ

What to include in an injury demand letter The date of the accident. Name of the insured. Policy number, if available. What parties were involved in the accident. Events leading up to and causing the accident. Detailed information regarding economic damages, broken down by category. Explanation of non-economic damages.

WCC ? Workers Compensation Claim Fill out the Report of Injury Form 07-6100 as soon as possible but no later than 30 days after your injury occurred or illness began. Keep a copy of the completed form for your records, and immediately give this form to your employer. You may send a copy to AWCB.

EMPLOYER: File the complete First Report of Injury (FROI), form 07-6101, with the Alaska Division of Workers' Compensation by electronic data interchange (EDI), or by mail, within 10 days of receiving this report, per AS 23.30. 070(a).

ALASKA WORKERS' COMPENSATION ACT (ACT). Employers who employ one or more workers must have workers' compensation insurance. An employer must buy the insurance from a licensed insurance company or be self-insured. Your employer cannot require you to pay any part of the insurance premium.

(a) The employer shall furnish medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus for the period which the nature of the injury or the process of recovery requires, not exceeding two years from and after the date of injury to the employee.

A detailed narrative progress/supplemental report is filed to document any significant change in the worker's medical or disability status. The employer must be notified by mail when an injured worker presents for the first visit without a written or personal referral from the employer.

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Alaska Sample Letter for Client's Injuries and Diagnosis