In uncontested cases, the beneficiaries and the employer/carrier can request that the North Carolina Industrial Commission enter an award without the need for presenting testimony. The parties are then to file the paperwork by joint stipulation. The paperwork can be filed electronically.
The paperwork has to include the following:
(1) A stipulation regarding all jurisdictional matters;
(2) The decedent’s name, social security number, employer, insurance carrier or servicing agent, and the date of the injury giving rise to this claim
3) A Form 22 Statement of Days Worked or Earnings of Injured Employee or stipulation as to average weekly wage;
(4) Any affidavits regarding dependents;
(5) The death certificate;
(6) A Form 29 Supplemental Report for Fatal Accidents;
(7) Guardian ad litem forms, if any beneficiary is a minor or incompetent;
(8) Proof of beneficiary status, such as marriage license, birth certificate, or divorce decree;
(9) Medical records, if any;
(10) A statement of payment of medical expenses incurred, if any; and
(11) A funeral bill or stipulation as to payment of the funeral benefit.
North Carolina Lawyer Joe Miller Advocates for Injured Employees
Attorney Joe Miller makes sure all agreements comply with the North Carolina laws and regulations. He’ll make sure the agreement contains all the correct information, all the right documents and is signed by all the right people and that the payment is sufficient. If you were injured at work, contact an experienced North Carolina Workers’ Compensation Lawyer to get the right result. Please give Joe Miller Law at 888-694-1671 and ask for me, Joe Miller, or email me at jmiller@joemillerinjurylaw.com. You can also complete the online form.
