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EMPLOYER’S FIRST REPORT OF INJURY OR …
WC-1 REVISION 12/2018 1 EMPLOYER’S FIRST REPORT OF INJURY OR OCCUPATIONAL DISEASE 1 OF 2 NOTE: FAILURE TO SUBMIT THIS REPORT TO INSURER IMMEDIATELY MAY RESULT IN PENALTY. MUST BE TYPED OR PRINTED IN BLACK INK. Board Claim No. Employee Last Name Employee First Name M.I. Date of Injury
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EMPLOYER’S FIRST REPORT OF INJURY OR …
sbwc.georgia.govwc-1 employer’s first report of injury or occupational disease georgia state board of workers' compensation notice to employer if you have questions please contact the state board of workers’ compensation at 404-656-3818 or 1-800-533-0682 or visit http://www.sbwc.georgia.gov
Subsection B: Payment Modifiers for Anesthesia …
sbwc.georgia.govSubsection B: Payment Modifiers for Anesthesia Services All anesthesia services are reported by use of the anesthesia five-digit procedure code (00100–01999) ...
NOTICE OF CLAIM - Workers' compensation
sbwc.georgia.govCheck only REQUEST one: 2NOTICE OF CLAIM ONLY2 HEARING / NOTICE OF CLAIM 2REQUEST FOR MEDIATION / NOTICE OF CLAIM. Complete a new Form WC-14 to add an additional employer, insurer or to add date of injury. If you need additional space, do not alter this form, but instead attach additional sheets. Must be typed or printed in black ink.
Workers’ Compensation Supervisor’s Manual
sbwc.georgia.govWorkers' compensation is a benefit program that provides medical and income benefits, and in certain circumstances, rehabilitation to an …
WORKERS’ COMPENSATION HANDBOOK
sbwc.georgia.govworkers’ compensation claims from the initial injury until the closing of the claim, and to safely return lost- time employees to productive employment. We believe that a healthy, safety conscious and productive
State Board Form WC-10 Notice of Election or …
sbwc.georgia.govwc-io notice of election or rejection of workers' compensation coverage georgia state board of workers' compensation notice of election or rejection
SUMMARY OF WORKERS' COMPENSATION PROVISIONS …
sbwc.georgia.govsummary of workers' compensation provisions georgia workers' compensation act amended on: 7/1/03 7/1/05 7/1/06 7/1/07 7/1/13 7/1/15 7/1/16
GEORGIA STATE BOARD OF WORKERS' COMPENSATION
sbwc.georgia.govbusiness address (month) (year) a copy of this form must be filed with your current workers' compensation carrier. if you do not have a carrier, and the business has 3 to 5 corporate officers or limited liability members and no employees, this form must be filed with the state board of workers' compensation at 270 peachtree street, n.w., atlanta, georgia 30303 -1299.
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