Form 07-6170 Employer's Notice of 45 Consecutive Days of Time Loss for Injuries - Alaska

Form 07-6170 Employer's Notice of 45 Consecutive Days of Time Loss for Injuries - Alaska

What Is Form 07-6170?

This is a legal form that was released by the Alaska Department of Labor and Workforce Development - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 07-6170?A: Form 07-6170 is the Employer's Notice of 45 Consecutive Days of Time Loss for Injuries in Alaska.

Q: Who needs to fill out Form 07-6170?A: Employers in Alaska need to fill out Form 07-6170 if an employee has been on time loss for 45 consecutive days due to an injury.

Q: What is the purpose of Form 07-6170?A: Form 07-6170 is used by employers to notify the Alaska Workers' Compensation Division about employees who have been on time loss for 45 consecutive days.

Q: Are there any deadlines for submitting Form 07-6170?A: Yes, employers are required to submit Form 07-6170 within 10 days of the 45th consecutive day of time loss for the injured employee.

Q: What information is required on Form 07-6170?A: Form 07-6170 requires information about the injured employee, details of the injury, and information about the employer and insurance coverage.

Q: Do I need to provide supporting documents with Form 07-6170?A: No, employers do not need to provide supporting documents with Form 07-6170. However, they should keep relevant records and documents for their own records.

Q: What should I do if I need help filling out Form 07-6170?A: If you need assistance with filling out Form 07-6170, you can contact the Alaska Workers' Compensation Division or your local workers' compensation office for guidance.

Q: Is there a fee for submitting Form 07-6170?A: No, there is no fee for submitting Form 07-6170 to the Alaska Workers' Compensation Division.

ADVERTISEMENT

Form Details:

  • Released on February 1, 2015;
  • The latest edition provided by the Alaska Department of Labor and Workforce Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 07-6170 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Alaska Department of Labor and Workforce Development.

Download Form 07-6170 Employer's Notice of 45 Consecutive Days of Time Loss for Injuries - Alaska

4.3 of 5 (37 votes)
  • Form 07-6170 Employers Notice of 45 Consecutive Days of Time Loss for Injuries - Alaska, Page 1
ADVERTISEMENT