PDF
Word
Form DLI-ERD-WCC001 Petition for Settlement - Injury / Od, Medical Benefits Reserved - Montana
What Is Form DLI-ERD-WCC001?
This is a legal form that was released by the Montana Department of Labor and Industry - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DLI-ERD-WCC001?
A: Form DLI-ERD-WCC001 is a Petition for Settlement - Injury/Od, Medical Benefits Reserved specifically for use in Montana.
Q: What is the purpose of Form DLI-ERD-WCC001?
A: The purpose of Form DLI-ERD-WCC001 is to request a settlement for a work-related injury or occupational disease while reserving the right to future medical benefits in Montana.
Q: Who should use Form DLI-ERD-WCC001?
A: Anyone who has suffered a work-related injury or occupational disease in Montana and wishes to seek a settlement while keeping their right to future medical benefits should use Form DLI-ERD-WCC001.
Q: What does 'Injury/Od' stand for in the form title?
A: 'Injury/Od' stands for 'injury or occupational disease' in the form title.
Q: Are medical benefits reserved in Form DLI-ERD-WCC001?
A: Yes, in Form DLI-ERD-WCC001, medical benefits are reserved, meaning that the petitioner retains the right to future medical benefits related to the injury or occupational disease.
Form Details:
- Released on October 7, 2011;
- The latest edition provided by the Montana Department of Labor and Industry;
- 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 DLI-ERD-WCC001 by clicking the link below or browse more documents and templates provided by the Montana Department of Labor and Industry.
