Form 9WCA-2 Application for Reimbursement of Paid Adjusted Total Disability Benefits From Special Fund for Active Cases, Rsa 281-a:29, 281-a:30 - New Hampshire

Form 9WCA-2 Application for Reimbursement of Paid Adjusted Total Disability Benefits From Special Fund for Active Cases, Rsa 281-a:29, 281-a:30 - New Hampshire

What Is Form 9WCA-2?

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.

FAQ

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.

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Form Details:

  • Released on September 1, 2015;
  • The latest edition provided by the New Hampshire Department of Labor;
  • 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 Form 9WCA-2 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Labor.

Download Form 9WCA-2 Application for Reimbursement of Paid Adjusted Total Disability Benefits From Special Fund for Active Cases, Rsa 281-a:29, 281-a:30 - New Hampshire

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