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This document is used for pretrial stipulations in workers' compensation cases in Kansas, outlining questions for both claimant and respondent regarding personal injury claims, employer-employee relationships,
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How to fill out K-WC 139
01
Gather necessary information: Collect personal and financial information required for the form.
02
Begin filling out the form with your name and contact details.
03
Provide your social security number and any relevant identification information.
04
Complete the sections regarding employment history, including job titles and dates of employment.
05
Fill in your income details and any additional sources of income.
06
Review the form for accuracy, ensuring all sections are completed.
07
Sign and date the form where indicated.
08
Submit the completed form to the appropriate agency or office.
Who needs K-WC 139?
01
Individuals who are applying for financial assistance or benefits related to their employment.
02
Workers who have experienced a job loss and are seeking unemployment benefits.
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What is K-WC 139?
K-WC 139 is a form used in the Kansas Workers Compensation system to report an injury or illness sustained by an employee.
Who is required to file K-WC 139?
Employers in the state of Kansas are required to file K-WC 139 when an employee suffers a work-related injury or illness that meets certain criteria.
How to fill out K-WC 139?
To fill out K-WC 139, employers must provide details about the employee, the nature of the injury or illness, the date it occurred, and any medical treatment related to the case.
What is the purpose of K-WC 139?
The purpose of K-WC 139 is to formally document workplace injuries to ensure that employees receive appropriate workers' compensation benefits and to maintain accurate records for compliance with state regulations.
What information must be reported on K-WC 139?
The information that must be reported on K-WC 139 includes the injured employee's details, the date and description of the injury or illness, medical treatment details, and information about any witnesses.
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