North Carolina 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

Benefit Amount: Two-Thirds of Your Weekly Average Earnings This percentage is designed to offer financial support and stability to injured employees while they recover from their workplace injury, regardless of their employment duration.

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 Industrial Commission Form 22 is the Statement of Days Worked and Earnings of Injured Employee. This form contains a table wherein the hours worked and wages earned over the 52 weeks prior to the employee's injury are recorded.

Filing the Documents Take the original and two (2) copies of the Motion to the Civil Division of the Clerk of Superior Court's office in the county where your case is filed. The Clerk will stamp each Motion ?filed,? place the original in the Court file and return two (2) copies of the ?filed? document to you.

A written report of the workplace accident must be submitted to your employer as soon as possible (ideally well before 30 days have elapsed). The report should include the date that the accident occurred, as well as a brief account of the injuries you have sustained.

The North Carolina Workers' Compensation Act requires that all businesses that employ three or more employees, including those operating as corporations, sole proprietorships, limited liability companies and partnerships, obtain workers' compensation insurance or qualify as self-insured employers for purposes of paying ...

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North Carolina Work Request Cover Sheet