PDF
Word
Form 110-I Agreement as to Compensation and Order Approving Settlement - Injury - Kentucky
What Is Form 110-I?
This is a legal form that was released by the Kentucky Department of Workers' Claims - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 110-I?
A: Form 110-I is an Agreement as to Compensation and Order Approving Settlement specifically for injuries in Kentucky.
Q: What is the purpose of Form 110-I?
A: The purpose of Form 110-I is to reach a settlement agreement regarding compensation for an injury and to obtain approval from the relevant authorities.
Q: Who uses Form 110-I?
A: Form 110-I is used by individuals in Kentucky who have suffered an injury and are seeking a settlement.
Q: What information does Form 110-I require?
A: Form 110-I requires information about the injured party, the employer, the nature of the injury, the proposed settlement amount, and other relevant details.
Q: What is the process for using Form 110-I?
A: The injured party and their employer must agree on a settlement amount and complete the form together. The form is then submitted to the appropriate authorities for approval.
Q: Is Form 110-I specific to Kentucky?
A: Yes, Form 110-I is specific to injuries in Kentucky and is used to comply with Kentucky's workers' compensation laws.
Form Details:
- Released on February 1, 2020;
- The latest edition provided by the Kentucky Department of Workers' Claims;
- 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 110-I by clicking the link below or browse more documents and templates provided by the Kentucky Department of Workers' Claims.
Download Form 110-I Agreement as to Compensation and Order Approving Settlement - Injury - Kentucky
1
2
3
4
5
