Form WC-5 Employee's Claim for Workers' Compensation - Hawaii

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Form WC-5 Employee's Claim for Workers' Compensation - Hawaii

What Is Form WC-5?

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

FAQ

Q: What is Form WC-5?
A: Form WC-5 is the Employee's Claim for Workers' Compensation in Hawaii.

Q: Who is this form for?
A: This form is for employees who have suffered a work-related injury or illness in Hawaii and want to file a workers' compensation claim.

Q: What information is required on Form WC-5?
A: Form WC-5 requires information such as the employee's personal details, employer's information, a description of the injury or illness, and other relevant details.

Q: How long do I have to file Form WC-5?
A: You should file Form WC-5 within 2 years of the date of the injury or illness, or within 2 years of the last date of payment of compensation.

Q: What happens after filing Form WC-5?
A: After filing Form WC-5, the claim will be reviewed by the workers' compensation insurer and a determination will be made regarding benefits.

Q: Do I need an attorney to file Form WC-5?
A: While you are not required to have an attorney to file Form WC-5, it may be beneficial to seek legal advice, especially if your claim is complex or disputed.

Q: What if my workers' compensation claim is denied?
A: If your workers' compensation claim is denied, you have the right to appeal the decision and seek further legal recourse.

Q: Can I receive wage replacement benefits while my claim is pending?
A: Yes, you may be eligible for temporary disability benefits while your workers' compensation claim is being processed.

Q: Are there any time limits for receiving workers' compensation benefits?
A: Yes, there are time limits for receiving workers' compensation benefits, depending on the nature and severity of the injury or illness.

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Form Details:

  • Released on January 1, 2022;
  • The latest edition provided by the Hawaii Department of Labor & Industrial Relations;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form WC-5 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Labor & Industrial Relations.

Download Form WC-5 Employee's Claim for Workers' Compensation - Hawaii

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