State Form 36097 Notice for Worker's Compensation and Occupational Diseases Coverage - Indiana

State Form 36097 Notice for Worker's Compensation and Occupational Diseases Coverage - Indiana

What Is State Form 36097?

This is a legal form that was released by the Indiana Workers' Compensation Board - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is State Form 36097?
A: State Form 36097 is the Notice for Worker's Compensation and Occupational Diseases Coverage form in Indiana.

Q: What is worker's compensation?
A: Worker's compensation is a state-mandated insurance program that provides benefits to employees who suffer work-related injuries or illnesses.

Q: What are occupational diseases?
A: Occupational diseases are illnesses or disorders that are caused by exposure to workplace hazards or conditions.

Q: Who needs to file State Form 36097?
A: Employers in Indiana are required to file State Form 36097 to notify their employees about their worker's compensation and occupational diseases coverage.

Q: What information is included in State Form 36097?
A: State Form 36097 includes information about the worker's compensation and occupational diseases coverage provided by the employer, as well as instructions for reporting work-related injuries and illnesses.

Q: Is worker's compensation mandatory in Indiana?
A: Yes, worker's compensation insurance is mandatory for most employers in Indiana.

Q: What benefits does worker's compensation provide?
A: Worker's compensation provides medical treatment, wage replacement, disability benefits, and vocational rehabilitation for employees who are injured or become ill due to their work.

Q: What should I do if I am injured at work?
A: If you are injured at work, you should report the injury to your supervisor or employer as soon as possible and seek medical attention if necessary. You should also fill out the necessary forms, such as the State Form 36097, to initiate a worker's compensation claim.

Q: Can I sue my employer for a work-related injury?
A: In most cases, you cannot sue your employer for a work-related injury if you are covered by worker's compensation insurance. Worker's compensation is designed to provide benefits to injured workers without the need for a lawsuit.

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Form Details:

  • Released on June 1, 2015;
  • The latest edition provided by the Indiana Workers' Compensation Board;
  • 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 fillable version of State Form 36097 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.

Download State Form 36097 Notice for Worker's Compensation and Occupational Diseases Coverage - Indiana

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  • State Form 36097 Notice for Workers Compensation and Occupational Diseases Coverage - Indiana, Page 1
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