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STATE BOARD OF WORKERS' COMPENSATION JUDGE RICHARD S. THOMPSON CHAIRMAN JUDGE WARREN MASSEY DIRECTOR 270 Peachtree Street, N.W. Atlanta, Georgia 30303-1299 www.sbwc.georgia.gov INFORMATION (404) 656-3818
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How to fill out a GA WC1 form:

01
Begin by gathering all the necessary information and documents for the form, such as the employee's personal details, injury information, and employer's information.
02
Start by completing the top section of the form, providing the injured employee's name, address, date of injury, and social security number.
03
Move on to the next section and provide details about the employer, including their name, address, and federal employer identification number (FEIN). If the employer is self-insured, include their self-insured number.
04
Fill out the injury information section, specifying the date, time, and description of the injury, as well as the body parts affected.
05
Provide any additional medical treatment details, including the names of healthcare providers, dates of treatment, and explanations of the services provided.
06
Complete the wage information section by entering the employee's average weekly wage and the number of dependents they have.
07
If the employee has missed work due to the injury, fill out the wage loss section, including the dates of missed work and any leave benefits received.
08
If any witnesses were present during the incident, provide their names, addresses, and phone numbers in the witness section.
09
Review the completed form for accuracy and ensure all required information has been provided.
10
Once reviewed, sign and date the form and have the employer or their representative sign it as well.

Who needs a GA WC1 form fill?

01
Employees who have suffered a work-related injury or illness in the state of Georgia are required to fill out a GA WC1 form.
02
Employers are also responsible for completing certain sections of the form, providing information about the company and the incident itself.
03
Healthcare providers may also be involved in the completion of the GA WC1 form, particularly in providing details about the medical treatment received by the employee.

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The ga wc1 form fill is a form used to report workers' compensation claims in the state of Georgia.
Employers in the state of Georgia are required to file the ga wc1 form fill for every workers' compensation claim made by their employees.
To fill out the ga wc1 form fill, you need to provide accurate information about the injured employee, the employer, the injury details, and the medical treatment received. The form can be filled out electronically or manually.
The purpose of the ga wc1 form fill is to properly report workers' compensation claims, ensure compliance with state regulations, and facilitate the processing of benefits for injured workers.
The ga wc1 form fill requires information such as the employee's name, address, occupation, date of injury, location of injury, witnesses, medical provider details, and a description of the injury or illness.
The deadline to file the ga wc1 form fill in 2023 is typically within one year from the date of injury or the date the employer had knowledge of the injury, whichever is later. However, specific deadlines may vary, and it is advisable to consult the Georgia State Board of Workers' Compensation for the exact deadline.
The penalty for the late filing of ga wc1 form fill in Georgia may vary depending on the circumstances and the discretion of the State Board of Workers' Compensation. It could result in fines, increased liability for the employer, or potential delays in the processing of the workers' compensation claim.
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