Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri

Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri

What Is Form WCLoD-1C?

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

FAQ

Q: What is Form WCLoD-1C?
A: Form WCLoD-1C is the Claim for Compensation for Line of Duty Compensation Benefits specifically for cases where a worker's death occurred on or after August 28, 2018 in the state of Missouri.

Q: What is Line of Duty Compensation Benefits?
A: Line of Duty Compensation Benefits are benefits provided to the dependents of a worker whose death was the result of an injury or illness incurred while performing their job duties.

Q: Who can file Form WCLoD-1C?
A: Form WCLoD-1C can be filed by the dependents of a worker who died on or after August 28, 2018, due to a job-related injury or illness.

Q: What is the purpose of Form WCLoD-1C?
A: The purpose of Form WCLoD-1C is to initiate a claim for Line of Duty Compensation Benefits for the dependents of a worker who died as a result of a job-related injury or illness.

ADVERTISEMENT

Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the Missouri Department of Labor and Industrial Relations;
  • 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 WCLoD-1C by clicking the link below or browse more documents and templates provided by the Missouri Department of Labor and Industrial Relations.

Download Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri

4.7 of 5 (13 votes)
  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri

    1

  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri, Page 2

    2

  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Worker's Death Occured on or After August 28, 2018) - Missouri, Page 3

    3

  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Workers Death Occured on or After August 28, 2018) - Missouri, Page 1
  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Workers Death Occured on or After August 28, 2018) - Missouri, Page 2
  • Form WCLoD-1C Claim for Compensation for Line of Duty Compensation Benefits (When Workers Death Occured on or After August 28, 2018) - Missouri, Page 3
Prev 1 2 3 Next
ADVERTISEMENT

Related Documents