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Workers Compensation Network. Acknowledgement. I have received information that tells me how to get health care under workers' compensation insurance.Each employee must sign this form when you begin the program or within 3 days of being hired, and at the time an injury occurs. Stop Payment - Form 1003, This document is a PDF. Signing this form is an acknowledgment of your rights and duties. FOREWORD. This material is a compilation of the statutes and certain rules of court pertaining to the. New Jersey Workers' Compensation Law. Ask all employees to complete and return the acknowledgement form within a specific time frame (we suggest 7 days). iii. Acknowledgement of Emergency Employment Status. I have received the Notice of Network Requirements which informs me how to get health care under workers' compensation insurance.