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-3?
A: Form 9WCA-3 is an application for reimbursement of paid combined earnings differential.
Q: What is the Combined Earnings Differential?
A: The Combined Earnings Differential is a benefit provided by the Special Fund for Second Injuries in New Hampshire.
Q: What is RSA 281-a:15 III?
A: RSA 281-a:15 III is the section of the New Hampshire Revised Statutes Annotated that relates to the reimbursement of paid combined earnings differential.
Q: What is RSA 281-a:55?
A: RSA 281-a:55 is another section of the New Hampshire Revised Statutes Annotated that relates to the reimbursement of paid combined earnings differential.
Q: Who is eligible for reimbursement?
A: Individuals who have paid combined earnings differential and meet the criteria outlined in RSA 281-a:15 III and RSA 281-a:55 may be eligible for reimbursement.
Q: What should I do with the completed form?
A: Once the form is completed, you should submit it to the New Hampshire Department of Labor for processing.
Q: Is there a deadline for submitting the form?
A: The exact deadline for submitting the form may vary, so it is advisable to check with the New Hampshire Department of Labor for the most up-to-date information.
Q: Are there any fees associated with the application?
A: There may be fees associated with the application, such as filing fees or other administrative costs. It is recommended to review the instructions on the form or contact the New Hampshire Department of Labor for more information.
Q: Who can I contact for more information?
A: For more information or assistance with the reimbursement application, you can contact the New Hampshire Department of Labor.
Form Details:
Download a fillable version of Form 9WCA-3 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Labor.