This is a legal form that was released by the New Hampshire Department of Labor - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 9WCA-2?
A: Form 9WCA-2 is an application for reimbursement of paid adjusted total disability benefits from the Special Fund for Active Cases in New Hampshire.
Q: What is the Special Fund for Active Cases in New Hampshire?
A: The Special Fund for Active Cases in New Hampshire is a fund that provides reimbursement for adjusted total disability benefits.
Q: What is RSA 281-a:29 and 281-a:30?
A: RSA 281-a:29 and 281-a:30 are the New Hampshire statutes that outline the provisions for reimbursement of paid adjusted total disability benefits.
Q: Who can use Form 9WCA-2?
A: Form 9WCA-2 can be used by individuals or employers who have paid adjusted total disability benefits and are seeking reimbursement from the Special Fund.
Q: What information is required on Form 9WCA-2?
A: Form 9WCA-2 requires information such as the claimant's name, date of injury, total amount of benefits paid, and supporting documentation.
Q: Are there any deadlines for submitting Form 9WCA-2?
A: Yes, Form 9WCA-2 must be submitted within one year after the compensation is paid or due to be paid.
Q: How long does it take to receive reimbursement?
A: The processing time for reimbursement varies, but it typically takes several weeks to receive payment.
Q: Can I appeal if my reimbursement claim is denied?
A: Yes, if your reimbursement claim is denied, you have the right to appeal the decision.
Form Details:
Download a fillable version of Form 9WCA-2 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Labor.