DOL Form 5 Employee's Notice of Injury and Claim for Compensation - Vermont

What Is DOL Form 5?

This is a legal form that was released by the Vermont Department of Labor - a government authority operating within Vermont. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DOL Form 5?
A: DOL Form 5 is the Employee's Notice of Injury and Claim for Compensation form.

Q: What is the purpose of DOL Form 5?
A: The purpose of DOL Form 5 is for employees in Vermont to report an injury or illness sustained in the workplace and file a claim for compensation.

Q: Who should complete DOL Form 5?
A: The injured employee or their representative should complete DOL Form 5.

Q: When should DOL Form 5 be completed?
A: DOL Form 5 should be completed as soon as possible after the injury or illness occurs.

Q: What information is required on DOL Form 5?
A: DOL Form 5 requires information such as the employee's personal details, details of the injury or illness, and the employer's information.

Q: What happens after submitting DOL Form 5?
A: After submitting DOL Form 5, the claim will be reviewed by the Vermont Department of Labor, and if approved, the employee may be eligible for compensation benefits.

Q: Is there a deadline for submitting DOL Form 5?
A: Yes, DOL Form 5 must be submitted within six months of the date of injury or onset of illness.

Q: Are there any fees associated with filing DOL Form 5?
A: No, there are no fees associated with filing DOL Form 5.