Kentucky Work Request Cover Sheet

State:
Multi-State
Control #:
US-212-AZ
Format:
PDF; 
Rich Text
Instant download

Description

A cover sheet is an informational form required to be filed in certain cases. The coversheet contains names and addresses of parties, the case type, and other organizational information. The court uses this information for statistical purposes and to organize the case for hearing. This form, a Work Request Cover Sheet for the type of case indicated (or a general cover sheet) is available for download now in standard format(s). USLF control no. US-212-AZ

How to fill out Work Request Cover Sheet?

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FAQ

Under Kentucky workers' comp laws, certain employees are exempt from coverage, including: Any person employed in agriculture. Members of a religious sect or organization that oppose insurance benefits. Kentucky Workers' Compensation | The Hartford thehartford.com ? workers-compensation thehartford.com ? workers-compensation

Total Temporary Disability (TTD) benefits are paid by your employer's workers' compensation insurance carrier. There is a seven-day waiting period. On the eighth day, the carrier will start your TTD benefits.

Workers receiving a lost wage benefit are paid at two-thirds of his or her regular weekly base wage. You will also be evaluated by a physician who will determine any physical impairments or limitations as a result of the injury.

? ??????Workers' Compensation First Report of Injury or Illness. Reminder: The First Report of Injury (IA-1) must be submitted by the supervisor (or designee) immediately after notification of injury. The first report of injury must be completed "within three (3) working days" per KRS 342.038, after the injury.

Employees representing themselves may file the form electronically through LMS or use a paper form. When a claim is filed it is routed to the Division of Claims Processing for review and docket assignment. The Department will issue an order assigning the case to an ALJ and schedule a Benefit Review Conference (BRC). How to File a Claim - Kentucky Education and Labor Cabinet ky.gov ? Workers-Compensation ? Pages ? Ho... ky.gov ? Workers-Compensation ? Pages ? Ho...

The increase in maximum weekly income benefits under the Workers' Compensation Act for total disability or death for the year 2021 over the year 2020 did amount to two dollars ($2.00) or more; therefore, the maximum weekly indemnity benefit for calendar year 2023 for total disability shall be $1,118.43.

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Kentucky Work Request Cover Sheet