GA WC-25 2022-2025 free printable template
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WC25 APPLICATION FOR LUMP SUM / ADVANCE PAYMENTGEORGIA STATE BOARD OF WORKERS' COMPENSATION
APPLICATION FOR LUMP SUM / ADVANCE PAYMENT
APPLICATION
OBJECTION
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How to fill out application for lump sum
How to fill out GA WC-25
01
Obtain a copy of the GA WC-25 form from the appropriate state website or office.
02
Fill in your personal information, including your name, address, and social security number at the top of the form.
03
Provide the details of your employer, including their name, address, and phone number.
04
Fill in the date of the injury or illness in the designated section.
05
Describe the nature of the injury or illness clearly and concisely.
06
Indicate the type of medical treatment you have received, if any.
07
Sign and date the form at the bottom to verify that the information is accurate.
08
Submit the completed form to the designated workers' compensation office as instructed.
Who needs GA WC-25?
01
Employees who have been injured on the job or have a work-related illness.
02
Employers who are filing on behalf of their employees for workers' compensation claims.
03
Medical professionals providing treatment related to work injuries.
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What is GA WC-25?
GA WC-25 is a form used in Georgia to report workplace injuries and illnesses for workers' compensation claims.
Who is required to file GA WC-25?
Employers in Georgia who have employees that have experienced a work-related injury or illness are required to file GA WC-25.
How to fill out GA WC-25?
To fill out GA WC-25, employers must provide details about the employee, the nature of the injury or illness, incident date, and any medical treatment provided.
What is the purpose of GA WC-25?
The purpose of GA WC-25 is to document work-related injuries and illnesses for the purpose of processing workers' compensation claims.
What information must be reported on GA WC-25?
The information that must be reported on GA WC-25 includes the employee's details, type of injury or illness, date and time of the incident, location, and the circumstances surrounding the event.
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