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Workers Compensation Claim Kit New HampshireBHHC Workers Compensation Representing Financial Strength & Integrity BHC.combat NH Claims Kit Introductory Letter 09/07/2017 (page 3 of 17) BHC Requirements
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How to fill out workers compensation claim kit

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How to fill out workers compensation claim kit

01
Start by obtaining the workers compensation claim kit from your employer or insurance company.
02
Read all the instructions carefully before you begin filling out the form.
03
Gather all the necessary documents such as medical records, accident reports, and wage statements.
04
Begin the form by providing your personal information such as your name, address, social security number, and contact details.
05
Fill in details about the date, time, and location of the work-related accident or illness.
06
Describe in detail how the accident or illness occurred, including the tasks you were performing at the time.
07
Provide information about any witnesses to the incident, if applicable.
08
Fill out the medical section by documenting the healthcare providers you have seen, the treatments you have undergone, and any medications prescribed.
09
Provide information about your employment history, including previous jobs and employers.
10
Calculate and include your average weekly wages to determine the compensation you may be eligible for.
11
Review the completed claim kit thoroughly and make sure all the required sections are filled out correctly.
12
Sign and date the claim form, and keep a copy for your records.
13
Submit the filled-out claim kit to your employer or insurance company as instructed.
14
Follow up with your employer or insurance company to track the progress of your claim.

Who needs workers compensation claim kit?

01
Workers who have suffered a work-related injury or illness and wish to seek compensation for medical expenses, lost wages, and other financial damages need a workers compensation claim kit.
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Workers compensation claim kit is a set of forms and documents provided by an employer to an employee who has been injured on the job, to initiate a claim for benefits.
The injured employee is required to file the workers compensation claim kit.
The employee must fill out the forms with relevant information about the injury, treatment received, and any impact on work abilities.
The purpose of the workers compensation claim kit is to help the injured employee seek benefits for medical treatment and lost wages due to a work-related injury.
Information such as the date and location of the injury, description of the injury, medical treatment received, and any witnesses to the incident must be reported on the claim kit.
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