DOL Form 28 Notice of Change in Compensation Rate (For Injuries After July 1, 1986) - Vermont

What Is DOL Form 28?

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

FAQ

Q: What is DOL Form 28?
A: DOL Form 28 is a Notice of Change in Compensation Rate form.

Q: Who is this form for?
A: This form is for injured workers in Vermont who have experienced a change in their compensation rate.

Q: When should this form be used?
A: This form should be used when there is a change in the compensation rate for injuries that occurred after July 1, 1986.

Q: What information is required on DOL Form 28?
A: DOL Form 28 requires information such as the injured worker's name, address, date of injury, and details of the change in compensation rate.

Q: Is there a deadline for submitting DOL Form 28?
A: Yes, DOL Form 28 should be submitted within 21 days of the date of the change in compensation rate.

Q: Who should I contact if I have questions about DOL Form 28?
A: If you have questions about DOL Form 28, you can contact the Vermont Department of Labor or seek assistance from your employer or workers' compensation insurance carrier.