The Mississippi Premiering Statement of Claimant/Employer-Carrier: (Revised 03/15/08) is a document used to provide information regarding a workers' compensation claim prior to a hearing. This document is required by the Mississippi Workers' Compensation Commission and must be submitted within 21 days of an employer receiving notice of a claim. The document includes information such as the claimant's name, address, and phone number, the employer's name, address, and phone number, and the date and time of the incident that led to the claim. It also includes a description of the incident, the injuries sustained, and the medical treatment provided. Additionally, the form requires the employer to provide information about any benefits or payments they have made to the claimant, any disputed facts about the claim, and any defenses they have to the claim. There are two types of Pre-Hearing Statements: one for the claimant and one for the employer/carrier.