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North Carolina Industrial Commission IC File #EMPLOYEES APPLICATION FOR ADDITIONAL MEDICAL COMPENSATION (G.S. 9725.1)EMP. Code # Carrier Code #(APPLICABLE TO INJURIES BY ACCIDENT OR OCCUPATIONAL DISEASES
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To fill out the North Carolina Industrial Commission form, follow these steps:
02
Obtain the form from the official North Carolina Industrial Commission website or from your employer.
03
Read the instructions provided with the form to understand the information required.
04
Fill in the personal details section accurately, including your name, address, and contact information.
05
Provide information about your employer, such as the company name and address.
06
Include details about your job position and the type of work you were performing.
07
Describe the circumstances of your injury or illness and how it occurred.
08
Attach any supporting documents or medical records that may be necessary to substantiate your claim.
09
Review the completed form for accuracy and completeness before submitting it.
10
Submit the form to the North Carolina Industrial Commission using the designated submission method provided.
11
Keep a copy of the completed form and any supporting documents for your records.

Who needs north carolina industrial commission?

01
The North Carolina Industrial Commission is needed by individuals who have suffered a work-related injury or illness in the state of North Carolina. This includes employees who have been injured on the job and are seeking workers' compensation benefits.
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Employers also need the North Carolina Industrial Commission to fulfill their legal obligations regarding reporting and providing compensation for workplace injuries or illnesses.
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Additionally, healthcare providers and insurance carriers may need to interact with the North Carolina Industrial Commission to provide medical information and process claims related to work-related injuries or illnesses.
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The North Carolina Industrial Commission is the state agency responsible for administering and enforcing the Workers' Compensation Act.
Employers in North Carolina are required to file with the Industrial Commission if they have employees and are subject to the Workers' Compensation Act.
Employers can fill out and submit the necessary forms online through the Industrial Commission's website or by mail.
The purpose of the North Carolina Industrial Commission is to ensure that injured workers receive the benefits they are entitled to under the Workers' Compensation Act.
Employers must report employee wages, injuries, and other relevant information related to workers' compensation claims.
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