Form AR-A 2008-2024 free printable template

Form AR-A Ark. C ode Ann. 11-9-102(9)(D), 11-9-402 Revised 1-1-2008 ARKANSAS WORKERS' COMPENSATION COMMISSION 324 Spring Street, Little Rock, AR 72201 Mail: P.O. Box 950, Little Rock, AR 72203-0950

How to fill out workers comp waiver arkansas

How to fill out workers comp waiver Arkansas:

1. Obtain the workers comp waiver form from the Arkansas Workers Compensation Commission website or request it from your employer.
2. Fill in your personal information accurately, including your name, address, date of birth, and Social Security number.
3. Provide your employer's details, such as the company name, address, and contact information.
4. Clearly indicate the effective date of the waiver and the duration for which it applies.
5. Sign and date the waiver form to acknowledge your understanding and acceptance of its terms.
6. Submit the completed form to your employer or the appropriate authority as instructed.

Who needs workers comp waiver Arkansas:

1. Employees who wish to waive their rights to workers' compensation benefits in Arkansas.
2. Independent contractors or freelancers who are not considered employees.
3. Individuals who have been offered and accepted an alternative form of insurance or compensation coverage in lieu of workers' compensation.

People Also Ask about workers comp waiver arkansas

Does my employer have to hold my job while on workers comp in Arkansas?

Arkansas Workers' Compensation Law protects you from discrimination or termination as a result of your workers' compensation case. That said, your employer is not required to hold your job for you while you are out of the office on disability as a result of your workplace injury.

How long can you draw workers comp in Arkansas?

The length of your workers' compensation benefits depends on the severity of your injuries and your recovery time. Typically, you could expect to receive a percentage of your lost income for up to six months for a physical injury. In more severe cases, you could receive benefits for up to 450 weeks.

How long can you be on workers comp in Arkansas?

With minor injuries, work comp cases last a few weeks, and some major injuries can last years. In cases of permanent and total disability benefits, your work comp case can last the rest of your life.

Is workers comp insurance required in Arkansas?

Arkansas Workers' Compensation Commission. Insurance Requirements: Most employers in Arkansas with three or more employees are required by law to have Workers' Compensation insurance coverage for their employees.

What is form 43 CT WC?

The Form 43 is to be completed by the respondent (employer/workers' compensation insurance carrier) to notify the Administrative Law Judge, the claimant (employee/decedent), and all parties to the claim of its intention to deny the compensability of all or part of the claimant's claim to workers' compensation benefits.

How do I file for workers comp in Arkansas?

How to File a Workers' Compensation Claim in Arkansas Step 1: Notify Your Employer. Step 2: Try Resolving the Dispute Prior to Filing Forms. Step 3: Find the Correct Forms & Fill Them Out. Step 4: File and Serve Forms. Step 5: Attend All Mediation, Settlement Discussions, and Hearings. Step 6: Filing an Appeal.

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What is workers comp waiver arkansas?

A workers comp waiver in Arkansas is a document that employees can sign to waive their right to receive workers’ compensation benefits if they are injured on the job. Arkansas requires employers to provide workers’ compensation benefits for employees who are injured while performing their job duties. The waiver must be signed in front of a witness and must be filed with the Arkansas Workers’ Compensation Commission.

Who is required to file workers comp waiver arkansas?

In Arkansas, employers are required to file a workers’ compensation waiver if they have no employees or only one part-time employee who earns less than $1,000 per quarter.

How to fill out workers comp waiver arkansas?

Workers Compensation Waiver forms in Arkansas are available online from the Arkansas Workers Compensation Commission. These forms must be completed in full and signed by both the employer and employee. The waiver form must include the employee’s name, job title, date of hire, and a signature of consent. The employer must also provide information such as the business name, address, and contact information. A copy of the waiver form must also be kept on file.

What is the purpose of workers comp waiver arkansas?

The purpose of a workers compensation waiver in Arkansas is to allow employers to opt out of providing workers compensation insurance coverage for their employees. The waiver allows employers to be exempt from the Workers' Compensation Act, which requires employers to provide coverage to employees in the event of an injury or illness related to their employment.

What information must be reported on workers comp waiver arkansas?

In Arkansas, employers must report the following information on a workers' compensation waiver: the name and address of the employer, the name of the employee, the date of the waiver, the date of injury, the type of injury, the amount of compensation awarded, the name of the insurer, the date of the insurer's payment, a description of the benefits provided, and any other information the employer deems necessary.

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