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Tennessee Claim Form under T.C.A. 40-33-101

Category:
Tennessee Local County - Davidson - Criminal Court-General Sessions Court
State:
Tennessee
Control #:
TN-SKU-0508
Format:
PDF
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Description

Claim Form under T.C.A. 40-33-101 The Tennessee Claim Form under T.C.A. 40-33-101 is used to make a claim for workers' compensation benefits in the state of Tennessee. It is a legal document that must be completed and submitted to the Tennessee Department of Labor and Workforce Development in order to initiate a claim. There are three different types of Tennessee Claim Form under T.C.A. 40-33-101: Form C-1, Form C-2, and Form C-3. Form C-1 is used for death and permanent total disability claims; Form C-2 is used for temporary disability claims; and Form C-3 is used for medical-only claims. Each form requires specific information, including the name, address, and Social Security number of the injured worker, the date and nature of the injury, and any other relevant information. The forms must be signed and dated by the injured worker.

The Tennessee Claim Form under T.C.A. 40-33-101 is used to make a claim for workers' compensation benefits in the state of Tennessee. It is a legal document that must be completed and submitted to the Tennessee Department of Labor and Workforce Development in order to initiate a claim. There are three different types of Tennessee Claim Form under T.C.A. 40-33-101: Form C-1, Form C-2, and Form C-3. Form C-1 is used for death and permanent total disability claims; Form C-2 is used for temporary disability claims; and Form C-3 is used for medical-only claims. Each form requires specific information, including the name, address, and Social Security number of the injured worker, the date and nature of the injury, and any other relevant information. The forms must be signed and dated by the injured worker.

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Tennessee Claim Form under T.C.A. 40-33-101
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