NC Workers’ Compensation Forms

The government does love its forms. Cases involving NC workers’ compensation are no exception. There are more forms than one can possibly imagine! As plentiful as they are, each and every one of them is important in its own right. Below, you will find a list and brief description of some of the forms that could be involved in a workers’ compensation case. These are not all of the forms, by any means. But you will, after reading through them, have an initial understanding of what’s involved in the filing of a case under NC workers’ compensation laws.

For the best results, it is highly recommended that you consult a knowledgeable, reputable, and well-established attorney that is familiar with all of North Carolina’s workers’ compensation laws, forms, regulations, procedures, etc. No layman should be expected to shoulder the burden of something like this by themselves!

Now let’s take a look at those forms…

Form MSC8

A workers’ comp mediator uses this Mediated Settlement Agreement (if your case settles at mediation) to report to the Industrial Commission.

Form MSC4

For a workers’ compensation case, this form designates the mediator.

Form MSC2

This form is used for the Mediated Settlement Conference as a Petition for Ordering [a] Referring Case.

Form 28C

Pursuant to a Compromise Settlement Agreement, this is a report of a carrier/administrator or employer of Compensation and Medical Compensation [to be] Paid.

Form 24

A timely response to Form 24 is essential for an employee if they don’t think that the benefits they’re receiving should be stopped. If an employer wishes to terminate worker’s comp benefits, this is the form they file. It is an Application to Suspend or Terminate Payment of Compensation.

Form 25T

If, for medical treatment, an employee travels at or in excess of 20 miles round-trip, they are entitled to reimbursement for mileage. Form 25T lists an Itemized Statement of Charges for Travel.

Form 25P

To obtain prescription reimbursement, an employee files this list of Itemized Statement of Charges for Prescription Drugs.

Form 33

You may decide to file this form if you are receiving some or not all of what you feel are entitled benefits. Additionally, if, over medical care and other issues, you have a dispute with your employer, you can file a request for a hearing with this form. It is a Request That Claim Be Assigned for Hearing.

Form 18

If you have been injured on the job, this would be filed with the Industrial Commission after being fully completed. It is an Injured Worker Notice of Accident Claim.

Form 19

This is something that needs to be completed by your employer. It is a form for the Report of [an] Injury.

Cardinal Law Partners – Experienced Workers’ Compensation Attorneys

That’s just a sampling of what can be involved when filing for (or appealing) a workers’ compensation case in North Carolina.

When filing (or appealing) a worker’s comp case, your best bet is to acquire not just adequate but knowledgeable and experienced legal representation. At Cardinal Law Partners, we deal with worker’s compensation cases on a regular basis. For that reason, and so many more, when you need to file (or appeal), we’re one of the best teams to have on your side. To discuss the specifics of an occupational compensation case, contact us today. You’ve got everything to gain and nothing to lose because your initial consultation is free.