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COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT DIVISION OF WORKERS COMPENSATIONREQUEST FOR LUMP SUM PAYMENT (Permanent Partial, Permanent Total and Dependents Benefits) Claimant. C. #Date of InjuryEmployerInsurance

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What is request for lump sum?

A request for lump sum is a formal submission asking for a one-time payment of a specified amount.

Who is required to file request for lump sum?

Anyone who is eligible to receive a lump sum payment must file a request for lump sum.

How to fill out request for lump sum?

To fill out a request for lump sum, one must provide personal information, the amount requested, and any supporting documentation.

What is the purpose of request for lump sum?

The purpose of a request for lump sum is to receive a one-time payment rather than regular payments over time.

What information must be reported on request for lump sum?

The request must include the individual's name, contact information, identification number, requested amount, and reason for the lump sum payment.

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