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This document is a request form used in the State of California for resolving disputes related to the Supplemental Job Displacement Benefit under the Division of Workers\' Compensation.
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Who needs dwc - ad 1013355?
01
Individuals applying for workers' compensation benefits.
02
Employees seeking assistance with workplace injury claims.
03
Employers needing to report a workplace injury.
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Legal representatives or advocates assisting clients with claims.
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What is dwc - ad 1013355?
DWC - AD 1013355 is a form used by employers in the state of California to report information related to workers' compensation claims. It ensures compliance with state regulations.
Who is required to file dwc - ad 1013355?
Employers in California who have employees injured in the workplace and who are seeking workers' compensation benefits are required to file DWC - AD 1013355.
How to fill out dwc - ad 1013355?
To fill out DWC - AD 1013355, employers must provide the necessary information regarding the injured employee, the circumstances of the injury, and details about the workers' compensation benefits being claimed. Specific instructions are provided on the form itself.
What is the purpose of dwc - ad 1013355?
The purpose of DWC - AD 1013355 is to facilitate the reporting process of workplace injuries to ensure that employees receive the appropriate workers' compensation benefits as required by law.
What information must be reported on dwc - ad 1013355?
The form requires reporting details such as the employee's name and contact information, the nature of the injury, the date of the incident, and compensation spells, among other pertinent information related to the claim.
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