18 75 WCC Form AR-A: Application for Certificate of Non-Coverage [Filed by Individual Who is a Sole Proprietor, Partner or Member of a Limited Liability Company who elects to not be considered an employee]
| Jurisdiction | Arkansas |
| Library | Arkansas Form Book - Complete (2024 Supplement) |
-
- This document is available in original version only for vLex customers
View this document and try vLex for 7 days - TRY VLEX
- This document is available in original version only for vLex customers
- Books and Journals
- Chapter 18 WORKERS' COMPENSATION
- Arkansas Workers' Compensation Commission Forms
- 18 70 WCC Form I-A1: First Report of Injury or Illness [Filed by Respondent]
- 18 71 WCC Form AR-C: Claim for Compensation [Filed by Injured Employee or Employee's Attorney]
- 18 72 WCC Form AR-2: Employer's Intent to Accept or Controvert Claim [Filed by Respondents - usually completed by Claims Adjuster]
- 18 73 WCC Form AR-3: Physician's Report [Completed by physician]
- 18 74 WCC Form AR-4: Report of Compensation Paid/Suspension of Benefits [Filed by Respondents]
- 18 75 WCC Form AR-A: Application for Certificate of Non-Coverage [Filed by Individual Who is a Sole Proprietor, Partner or Member of a Limited Liability Company who elects to not be considered an employee]
- 18 76 WCC Form AR-D: Death and Permanent Total Disability Acceptance/Update [Filed with the Arkansas Workers' Compensation Commission by Respondents]
- 18 77 WCC Form AR-H: Health Care Notice for Employees Under Managed Care [This form is posted by the Employer]
- 18 78 WCC Form AR-L: Claimant's Lump Sum Request/Respondent's Position [This form is completed by both the Claimant and the Respondent]
- 18 79 WCC Form AR-M: Monthly Report on Medical-Only Injury Data [This form is completed by Respondents]
- 18 80 WCC Form AR-N: Employee's First Notice of Injury [Completed by the Claimant and given to his or her employer upon initial reporting of the injury]
- 18 81 WCC Form AR-O: Contact Designation Form for Claim Office/Medical Billing /Underwriter/Administrator [This form is filed by the Workers' Compensation Insurance Carrier or Self-Insured with the Arkansas Workers' Compensation Commission]
- 18 82 WCC Form AR-P: Workers' Compensation Instructions to Employers and Employees [This form is posted by the Employer]
- 18 83 WCC Form AR-R: Report of Mediation Conference [This form is completed by the Mediator at the Arkansas Workers' Compensation Commission]
- 18 84 WCC Form AR-S: Supplemental Report [This form is filed by Respondents with the Arkansas Workers' Compensation Commission]
- 18 85 WCC Form AR-V: Verification of Permanent Total Disability [This form is sent by the Special Funds Division of the Arkansas Workers' Compensation Commission or the Respondent to the Claimant to complete]
- 18 86 WCC Form AR-W: Wage Statement Immediately Preceding Injury Date [Filed by Respondents]
- Special Funds Division Forms
- 18 90 WCC Form SF-1: Notice of Claimant Information/Change of Address [Filed by the injured employee with the Special Funds Division to notify of a change of address or Emergency Contact]
- 18 91 WCC Form SF-2: Guardianship Affidavit (Court Appointed/Non-Minor) [Filed with the Special Funds Division of the Arkansas Workers' Compensation Commission by the Guardian for the injured employee]
- 18 92 WCC Form SF-3: Power of Attorney Notice and Affidavit [Filed with the Special Funds Division of the Arkansas Workers' Compensation Commission by the person holding power of attorney for the injured employee]
- 18 93 WCC Form SF-4: Surviving Spouse Notice and Affidavit [Filed with the Special Funds Division of the Arkansas Workers' Compensation Commission by the spouse of a deceased employee certifying that he or she has not remarried]
- 18 94 WCC Form SF-5: Guardian's Affidavit - Dependent Child(ren) [New] [Filed with the Special Funds Division of the Arkansas Workers' Compensation Commission by the guardian of a dependent child]
- 18 95 WCC Form SF-6: Affidavit for Dependents other than Spouse or Child [New] [Filed with the Special Funds Division of the Arkansas Workers' Compensation Commission by the dependent beneficiary.
- 18 96 WCC Form SF-8: Authorization for Release of Student Information [New] [Completed by dependent student beneficiary] and sent to Arkansas Workers' Compensation Commission Special Funds Division.
- 18 97 Arkansas Workers' Compensation Commission Forms Training Materials [New]
Subscribers can access the reported version of this case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a list of all the cited cases and legislation of a document.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a list of all the documents that have cited the case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see the revised versions of legislation with amendments.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see any amendments made to the case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a visualisation of a case and its relationships to other cases. An alternative to lists of cases, the Precedent Map makes it easier to establish which ones may be of most relevance to your research and prioritise further reading. You also get a useful overview of how the case was received.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see the list of results connected to your document through the topics and citations Vincent found.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.