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Form 113 Notice of Designated Physician - Kentucky
What Is Form 113?
This is a legal form that was released by the Kentucky Department of Workers' Claims - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 113?
A: Form 113 is a Notice of Designated Physician form used in Kentucky.
Q: What is the purpose of Form 113?
A: The purpose of Form 113 is to designate a physician for the treatment of a work-related injury or illness.
Q: Who needs to complete Form 113?
A: The employer or insurance company needs to complete Form 113.
Q: Are there any fees associated with Form 113?
A: No, there are no fees associated with Form 113.
Q: Is Form 113 required for all work-related injuries or illnesses?
A: Yes, Form 113 is required for all work-related injuries or illnesses in Kentucky.
Q: What information is required on Form 113?
A: Form 113 requires information such as the employee's name, employer's name, and designated physician's information.
Form Details:
- Released on March 12, 2003;
- The latest edition provided by the Kentucky Department of Workers' Claims;
- 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 113 by clicking the link below or browse more documents and templates provided by the Kentucky Department of Workers' Claims.
Download Form 113 Notice of Designated Physician - Kentucky
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