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WORKERS' COMPENSATION BENEFIT ELECTION FORM New York State Council 82, DYSTOPIA or PBA of NYS Negotiated Agreements To be completed by employee INSTRUCTIONS: Please complete this form and submit it
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What is workers' compensation benefit election?
Workers' compensation benefit election is a process in which an employee chooses whether to receive workers' compensation benefits in case of a workplace injury or illness.
Who is required to file workers' compensation benefit election?
All employees are required to file a workers' compensation benefit election form to indicate their decision regarding the receipt of benefits in case of an occupational injury or illness.
How to fill out workers' compensation benefit election?
To fill out a workers' compensation benefit election, employees need to complete the designated form provided by their employer. It typically requires basic personal information and the employee's decision regarding the receipt of benefits.
What is the purpose of workers' compensation benefit election?
The purpose of workers' compensation benefit election is to allow employees to make a formal decision on whether they want to receive workers' compensation benefits or waive their rights to them in case of a work-related injury or illness.
What information must be reported on workers' compensation benefit election?
On a workers' compensation benefit election form, employees usually need to report their full name, employee ID or social security number, contact information, and their decision to either elect or waive workers' compensation benefits.
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