MWCC Form B-19 Application for Lump Sum Payment - Mississippi

What Is MWCC Form B-19?

This is a legal form that was released by the Mississippi Workers' Compensation Commission - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form B-19?
A: Form B-19 is an application for a lump sum payment in the state of Mississippi.

Q: Who can use Form B-19?
A: Any individual who is eligible for workers' compensation benefits in Mississippi and wishes to receive a lump sum payment instead of weekly payments can use Form B-19.

Q: What is a lump sum payment?
A: A lump sum payment is a one-time payment of all or a portion of the workers' compensation benefits that an individual is entitled to.

Q: How do I fill out Form B-19?
A: You should provide your personal information, details of your employment, information about your injury, medical treatment, and any other relevant information requested in the form.

Q: What happens after I submit Form B-19?
A: The Mississippi Workers' Compensation Commission will review your application and determine whether to approve or deny your request for a lump sum payment.

Q: Is there a deadline for submitting Form B-19?
A: Yes, you must submit Form B-19 within one year from the date of your injury or the date of your last receipt of compensation benefits, whichever is later.

Q: Can I change my mind after submitting Form B-19?
A: No, once you submit Form B-19 and receive a lump sum payment, you cannot change your mind or request additional benefits for the same injury.