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WORKERS COMPENSATION BOARD OF INDIANA 402 WEST WASHINGTON STREET, ROOM W196 INDIANAPOLIS, IN 462042753 www.in.gov/wcbSTATE FORM 18488 9R13/3990 FORM SI1 (Revised 2018) Approved by State Board of AccountsWORKER
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01
Start by obtaining a copy of the workers compensation board form. This can usually be found on the official website of your state or country's workers compensation board.
02
Read through the instructions provided with the form to ensure that you understand all the requirements and necessary information that needs to be provided.
03
Begin by filling out your personal information, including your full name, contact information, and any relevant identification numbers. Make sure to double-check the accuracy of this information.
04
Next, provide details about your employer. This includes their business name, address, and contact information.
05
Fill in the date and time of your injury or illness, as well as the location where it occurred.
06
Provide a detailed description of the incident or injury, including how it happened and any contributing factors.
07
If you received medical treatment, include the name and contact information of the healthcare provider, as well as the dates and details of the treatment.
08
If there were any witnesses to the incident, provide their names and contact information, as they may be required to provide statements or testimony.
09
Review the completed form for any errors or missing information, as this could delay the processing of your claim.
10
Sign and date the form, affirming that the information provided is true and accurate.
11
Submit the completed form to the appropriate workers compensation board office as instructed.
12
Keep a copy of the form and any supporting documentation for your records.

Who needs workers compensation board of?

01
Workers compensation boards are typically needed by employees who have been injured or become ill as a result of their work.
02
Employers may also need to fill out workers compensation board forms if they have employees who have been injured or become ill.
03
It is important to consult with your local workers compensation board or legal counsel to determine if you are required to file a workers compensation claim.
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The workers compensation board is a government agency responsible for overseeing and enforcing workers' compensation laws.
All employers are required to file workers compensation board of.
Employers must provide information about their employees, wages, and work-related injuries on the workers compensation board of form.
The purpose of workers compensation board of is to ensure that employees who are injured or become ill on the job receive proper compensation and medical care.
Employers must report information such as employee names, job titles, wages, and details of any work-related injuries.
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