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This version of the form is not currently in use and is provided for reference only. Download this version of
Form D-10B
for the current year.
Form D-10B Election of Lump Sum Payment of Compensation for Disability Greater Than 30% Pursuant to Nrs 616c.495(1)(F), (2) and (3) - Nevada
What Is Form D-10B?
This is a legal form that was released by the Nevada Department of Business and Industry - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form D-10B?
A: Form D-10B is a form used in Nevada for electing a lump sum payment of compensation for disabilities greater than 30%.
Q: What is the purpose of Form D-10B?
A: The purpose of Form D-10B is to provide a written request for a lump sum payment of compensation for disabilities greater than 30%.
Q: What is NRS 616C.495(1)(F), (2) and (3)?
A: NRS 616C.495(1)(F), (2) and (3) refers to the specific sections of the Nevada Revised Statutes that outline the eligibility criteria and process for electing a lump sum payment of compensation for disabilities greater than 30%.
Q: Who can use Form D-10B?
A: Form D-10B can be used by individuals in Nevada who have disabilities greater than 30% and want to elect a lump sum payment of compensation.
Q: Is Form D-10B specific to Nevada?
A: Yes, Form D-10B is specific to Nevada and is used for workers' compensation cases in the state.
Q: Can I request a lump sum payment of compensation for disabilities less than 30% using Form D-10B?
A: No, Form D-10B is specifically for disabilities greater than 30%.
Q: What information is required on Form D-10B?
A: Form D-10B requires information such as the claimant's name, address, Social Security number, and details about the disability and the requested lump sum payment.
Q: Are there any deadlines for submitting Form D-10B?
A: Yes, Form D-10B must be submitted within 90 days from the date of the final decision regarding the claimant's compensation.
Q: Who should I contact if I have questions about Form D-10B?
A: For any questions about Form D-10B or the process of electing a lump sum payment of compensation, you should contact the Nevada Division of Industrial Relations.
Form Details:
- Released on October 1, 2022;
- The latest edition provided by the Nevada Department of Business 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 D-10B by clicking the link below or browse more documents and templates provided by the Nevada Department of Business and Industry.
Download Form D-10B Election of Lump Sum Payment of Compensation for Disability Greater Than 30% Pursuant to Nrs 616c.495(1)(F), (2) and (3) - Nevada
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