The purpose of this project is to evaluate claims and practice completing Employee Claim forms use Maryland worker compensation form
Course Outcomes met by this project:
Gather information from various sources and utilize forms and documents to support client goals
Research workers compensation law, complete workers compensation forms
Karver has tasked you with completing the Employee Claim form that will be filed with the Workers Compensation Commission in Baltimore on behalf of a client injured on-the-job.
The injured client and claimant is John Howard who lives at 1234 Tree Lane, Olney, MD 20852. His date of birth is March 5, 1965 and the last 4 digits of SSN are 4510. His phone number is 240.435.6677.
He injured his back when he slipped on the floor of the packaging section of the manufacturing plant for ABC Corporation, his employer. He advised his supervisor, Gale Brown about the injury on May 2, 2020. The injury happened on May 1, 2020, around 11 am (he can’t recall exact time). No one witnessed the accident.
Howard did not go to the hospital but has been treated with Dr. Leadbetter at 4545 Doctor’s Lane, Olney, MD 20852 since May 2, 202 and he will probably need more treatment.
At the time of the accident, Howard was earning $500 per week. ABC Corporation has paid Howard his salary from the date of the accident and has paid his medical bills. Howard has not personally received any bills from his doctor for treatment.
This is all the information available, so complete the form as fully as possible.
FIND and Print out and complete the Employee’s Claim form, scan and post in the Assignment folder. If you have problems scanning the document, notify the Professor.
If there is any missing information, create a bullet list, identifying the additional information that might be necessary for completion of this form.
Review the Project Before Submitting It
Thoroughly read the presentation to ensure all required elements are present.
Review the grading rubric to ensure that you gain the most points possible for this assignment.
Proofread for errors
Project due by 11:59 pm ET Tuesday June 8th
The purpose of this project is to evaluate claims and practice completing Employee Claim forms.
Course Outcomes met by this project:
• Gather information from various sources and utilize forms and documents to support client goals
• Identify and analyze issues related to workers compensation
• Research workers compensation law, draft legal writings, complete workers compensation forms
Please refer to Project 1 in week 2, and the Learning Activity in week 3 for background information about the Howard case.
Karver informs you that she has settled John Howard’s Workers Compensation Commission case for $15,000.00. This is a full and final settlement with all medicals closed out.
Karver informs you that there is no SIF (Subsequent Injury Fund) involvement and that the Claimant, John Howard, has returned to work.
Howard not eligible for Medicare.
Karver tasks you with completing the settlement worksheet and affidavit in support of settlement for Howard’s case given all the information know at this point.
1. Print out and complete the settlement forms, scan and post in the Assignment folder. If you have problems scanning the document, please contact the Professor.
2. If additional information is needed, create a bullet list of the information items needed so that the information can be obtained from the client. Submit the list with the completed settlement forms.
Following submission of the settlement forms for the Howard case, Karver tells you that the settlement of $15,000.00 for Howard has fallen through.
Instead, the claimant and Employer are going to enter a Stipulation of 15% permanency for Howard’s back injury.
Karver has given you the responsibility of completing a Stipulation form for the Howard claim.
Print and complete the Stipulation form to be submitted to the Workers Compensation Commission for approval.
If you’re looking for a form use the worker’s compensation form for the State of Maryland if I find one in a day I will attach it.