This version of the form is not currently in use and is provided for reference only. Download this version of Form DWC-05 for the current year.
This is a legal form that was released by the Rhode Island Department of Labor and Training - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form DWC-05?
A: Form DWC-05 is the Suspension Agreement and Receipt form used in Rhode Island.
Q: What is the purpose of Form DWC-05?
A: The purpose of Form DWC-05 is to document the agreement to suspend workers' compensation benefits in Rhode Island.
Q: Who needs to use Form DWC-05?
A: Form DWC-05 needs to be used by individuals or entities involved in a workers' compensation case in Rhode Island who have reached an agreement to suspend benefits.
Q: What information is required on Form DWC-05?
A: Form DWC-05 requires information such as the injured worker's name, date of injury, insurance carrier, and the reason for the suspension.
Q: Is there a deadline to submit Form DWC-05?
A: There is no specific deadline mentioned for submitting Form DWC-05, but it should be submitted as soon as an agreement to suspend benefits is reached.
Q: What happens after submitting Form DWC-05?
A: After submitting Form DWC-05, the Workers' Compensation Court will review the agreement and issue a decision on whether to approve the suspension of benefits.
Form Details:
Download a fillable version of Form DWC-05 by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Labor and Training.