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DRAFT Nonprejudicial Agreement Claim Administrator Claim Number RI Department of Labor and Training, Division of Workers Compensation PO Box 20190, Cranston, RI 029200942 www.dlt.ri.gov/wc Phone 4014628100
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How to Fill Out NP DWC 20 Draft18:

01
Begin by acquiring the NP DWC 20 Draft18 form. This form is typically required when filing for a workers' compensation claim in certain states.
02
Fill in the top section of the form, which will require you to provide your personal information. This includes your name, address, phone number, and social security number.
03
Move on to the next section, where you will need to provide details about your employer. Fill in their name, address, and contact information.
04
The following section of the form requires you to describe the injury or illness you have sustained. Provide a thorough account, including the date, time, and location of the incident.
05
Indicate whether the injury resulted in missed workdays and specify the dates.
06
Next, you will need to explain the treatment you received or are currently receiving for your injury or illness. This includes the name of the medical provider and the type of treatment received.
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In the subsequent section, describe any previous workers' compensation claims you have filed for the same or similar injury.
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If you have witnesses who can support your claim, provide their names, addresses, and phone numbers in the designated section.
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Finally, sign and date the form to certify that the information you've provided is accurate and complete.

Who Needs NP DWC 20 Draft18:

01
Employees who have sustained a work-related injury or illness and wish to file a workers' compensation claim.
02
Employers who are required by law to provide workers' compensation benefits to their employees.
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Insurance companies or claims administrators responsible for processing workers' compensation claims and assessing liability.
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np dwc 20 draft18 stands for Nonprofit Data Workshops and Conferences 2020 Draft 18.
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