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FORM 17Revised 11/2014 N. C. WORKERS COMPENSATION NOTICE TO INJURED WORKERS AND EMPLOYERS All employees of this business, except specifically excluded executive officers, suffering work related injuries
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How to fill out nc workers compensation notice

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How to fill out nc workers compensation notice

01
To fill out the NC Workers Compensation Notice, follow these steps:
02
Obtain the necessary forms: You will need Form 18, which is the Employee's Notice of Accident to Employer, and Form 25T, which is the Employer's Accident Report.
03
Fill out Form 18: Provide all required information in Form 18, such as your name, address, and contact details. Describe the accident, injuries, and medical treatment received. Sign and date the form.
04
Fill out Form 25T: The employer should complete Form 25T, providing details about the accident, witness statements, and any available insurance information. The employer should also sign and date the form.
05
Exchange the forms: Once both forms are completed, the employee should provide the signed Form 18 to their employer, and the employer should provide the completed Form 25T to the employee.
06
Retain a copy: Make sure to keep a copy of both forms for your records.
07
Note: It is recommended to consult with a legal professional or your employer's HR department for accurate guidance in filling out the NC Workers Compensation Notice.

Who needs nc workers compensation notice?

01
The NC Workers Compensation Notice is needed by employees who have suffered a work-related injury or illness in the state of North Carolina. It is generally required to be completed by employees who wish to file a claim for workers' compensation benefits. The notice helps provide necessary information about the accident and injuries to the employer and the workers' compensation insurance carrier.
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The NC workers compensation notice is a form that employers in North Carolina are required to file to report work-related injuries or illnesses.
Employers in North Carolina are required to file the NC workers compensation notice.
The NC workers compensation notice can be filled out online or submitted in paper form with details of the work-related injury or illness.
The purpose of the NC workers compensation notice is to report work-related injuries or illnesses to the appropriate authorities for processing and compensation.
The NC workers compensation notice must include details such as the date of the injury or illness, location, and a description of the incident.
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