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WORKERS COMPENSATION FIRST REPORT OF INJURY OR ILLNESSEMPLOYER (NAME AND ADDRESS INCL. ZIP)City of Gulfport Post Office Box 1780 Gulfport, MS 39502 SIC CODECARRIER/ADMINISTRATOR CLAIM NUMBER JURISDICTIONREPORT

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How to fill out mwcc - workers compensation

01

Gather all necessary information such as employee details, injury details, date of injury, etc.

02

Complete the form accurately and in detail.

03

Submit the completed form to the relevant authority or insurance company.

Who needs mwcc - workers compensation?

01

Employers who have employees injured on the job and are seeking compensation for medical expenses and lost wages.

02

Employees who have been injured on the job and need to file a workers' compensation claim.

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What is mwcc - workers compensation?

Workers' compensation is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee's right to sue their employer for the tort of negligence.

Who is required to file mwcc - workers compensation?

Employers are required to file workers' compensation insurance to ensure coverage for employees in case of work-related injuries or illnesses.

How to fill out mwcc - workers compensation?

Employers must complete the necessary paperwork provided by the insurance carrier and submit it as instructed to ensure proper coverage for workers' compensation benefits.

What is the purpose of mwcc - workers compensation?

The purpose of workers' compensation is to provide financial protection for employees who are injured on the job, covering medical expenses and lost wages resulting from work-related injuries or illnesses.

What information must be reported on mwcc - workers compensation?

Employers must report information such as employee injuries, medical treatment received, time off work, and any other relevant details related to the work-related injury or illness.

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