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North Carolina Forms

79 State Forms found

name	number	revision	print or send online
EMPLOYER’S REPORT OF EMPLOYEE’S INJURY OR OCCUPATIONAL DISEASE TO THE INDUSTRIAL COMMISSION	FORM 19	9/2020
N.C. WORKERS’ COMPENSATION NOTICE TO INJURED WORKERS AND EMPLOYERS	Form 17	Revised 12/2020
RETURN TO WORK REPORT	FORM 28	09/2023
AFFIDAVIT OF ACCRUED ARREARAGES G.S. 97-87(d)	Form 87A	03/2020
AGREEMENT FOR COMPENSATION FOR DEATH	FORM 30	12/2020
AGREEMENT FOR COMPENSATION FOR DISABILITY	FORM 21	3/2021
AGREEMENT FOR PAYMENT OF UNPAID COMPENSATION IN UNRELATED DEATH CASES (G.S. 97- 37)	FORM 26D	03/2020
ANNUAL CONSOLIDATED FISCAL REPORT OF “MEDICAL ONLY” AND “LOST TIME” CASES	FORM 51	02/2017
APPLICATION FOR APPOINTMENT OF GUARDIAN AD LITEM	Form T-42	3/2020
APPLICATION FOR LUMP SUM AWARD	FORM 31	03/2020
APPLICATION FOR REVIEW	FORM T-44	03/2019
APPLICATION TO REINSTATE PAYMENT OF DISABILITY COMPENSATION (G.S. 97-18(k))	FORM 23	10/2021
APPLICATION TO TERMINATE OR SUSPEND PAYMENT OF COMPENSATION (G.S. 97-18.1)	FORM 24	03/2020
AUTHORIZATION FOR REHABILITATION PROFESSIONAL TO OBTAIN MEDICAL RECORDS OF CURRENT TREATMENT	Form 25C	03/2020
AWARD APPROVING AGREEMENT FOR COMPENSATION FOR DEATH	Form 30D	03/2020

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Disclaimer: These forms may not be the most recent version. North Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.

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