Workers Compensation Agreement Sample Contracts

Contract
Workers' Compensation Agreement • June 9th, 2008 • Ohio

This contract, by and among (Organization Name, Street Address, City, State, ZIP code, policy number) (“Employer”) and the Administrator of the Ohio Bureau of Workers’ Compensation, entered into pursuant to the authority contained in Section 4123.039 of the Ohio Revised Code, in consideration of mutual promises, agreements and covenants herein contained. 1. DefinitionsThe definitions below, when used with an initial capital letter or letters, shall apply throughout this contract.1.1 Administrator means the Administrator of the Ohio Bureau of Workers’ Compensation, or their designee.1.2 Bureau means the Ohio Bureau of Workers’ Compensation, an agency of the State of Ohio government.1.3 Code means the Ohio Revised Code, as amended from time to time.1.4 Apprentices mean apprentices as defined under Section 4139.01 of the Code, and pre-apprentices, entry-level trainees and journeyperson trainees as defined collectively in Section 4123.038 of the Code.1.5 Administrative Code means the Ohi

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OFFICE OF WORKERS’ COMPENSATION AGREEMENT AS TO COMPENSATION PAID
Workers' Compensation Agreement • July 10th, 2013

The above have reached an agreement in regard to compensation for the injury sustained by said employee and submit the following statement of facts relative thereto:

Group Self-Insured Workers' Compensation Plan
Workers' Compensation Agreement • January 21st, 2021 • Minnesota
WORKERS’ COMPENSATION AGREEMENT
Workers’ Compensation Agreement • January 11th, 2011
ATTACHMENT “B”
Workers Compensation Agreement • October 3rd, 2021
WORKERS’ COMPENSATION RESIDENCE EMPLOYEES – CALIFORNIA
Workers' Compensation Agreement • August 11th, 2014
NEGOTIATED WORKERS’ COMPENSATION AGREEMENT BETWEEN
Workers' Compensation Agreement • July 31st, 2009

Hereby accepts, adopts, and agrees to be bound by each and every term and provision contained in that certain NEGOTIATED WORKERS’ COMPENSATION AGREEMENT, made and entered into November 1, 1994 at Orlando Orange County, Florida between the Broward Building Trades Council, Florida Gulf Coast Building Trades Council, Greater Orlando Building Trades Council, Miami Building Trades Council, Mobile/Pensacola Building Trades Council, Northeast Florida Building Trades Council, and the Palm Coast Building Trades Council, and all affiliated Local Unions who are bound to the NEGOTIATED WORKERS’ COMPENSATION AGREEMENT by virtue of their authorized signatures contained within EXHIBIT “A”.

In a continuing effort to improve benefits for its members, UUP has entered into an agreement with a statewide law firm that concentrates on Workers’ Compensation and Social Security Disability and focuses its efforts on union members and their...
Workers’ Compensation Agreement • May 23rd, 2005

This relationship will benefit you in many ways. FOA will assist in completing all the paperwork necessary to file a Workers’ Compensation claim, guide it through the com- plicated process, monitor it to ensure that medical providers are filing the correct forms, and represent you at every hearing.

Kahnawà:ke Worker's Compensation MSI A Application Agreement Form
Worker's Compensation Agreement • March 12th, 2013

Company/Organization Name: Company/Organization Owner Name: Extension: Company/Organization Owner E-mail Address: Company/Organization Address: Company/Organization Telephone Number: Company/Organization Fax Number: Finance Contact Name: Extension: Finance Contact E-mail Address: Finance Contact Telephone Number: Human Resource Contact Name: Extension: Human Resource Contact E-mail Address: Human Resource Contact Telephone Number: Mode Of Payment: 🞎 Monthly 🞎 Bi-Yearly 🞎 Yearly 🞎 Duration Of Project: (Start Date - End Date) 🞎 Seasonal: ( Date of Operation: From - To) *For Duration of Project or Seasonal; If you exceed the end date written above you must inform Mohawk Self Insurance. In the event you do not inform Mohawk Self Insurance and an injury occurs the claim will be denied. Does your Company/Organization Safety Program: 🞎 Yes 🞎 No * Must Provide Mohawk Self Insurance with a copy of your Company/Organization's Safety Program. For

Worker’s Compensation Agreement
Worker’s Compensation Agreement • July 31st, 2019

Welcome to Fyzical Campbell, Previously known as Myofascial Therapy Center! We take pride in the quality of our staff and in the services we provide for you. The best service is based upon friendly, mutual under- standing between the therapist, patient, and our front office staff. In order to achieve that, we want to explain our treatment policy prior to beginning treatments.

FLOOR DEBATE
Workers' Compensation Agreement • March 3rd, 2024

does...this agreement does two things, I think. It e s tablishes a l i ne of t en , whi ch i s f ai r l y s i zea b l e . Tha t ' s pr ob a b l y e quivalent to, if you figure one employee per 1 , 000 h ead o f cattle, cattle feeding, 10 ,000 head of cattle feeding. Hogs, I'm not sure how many. But certainly there are many e m ployers who are o ver that. B u t we' re also hearing that...and feeling that perhaps if they' re that large and they' re hiring that many nonrelated folks, maybe i t' s b est if they carry the workers' comp coverage. Now, workers' comp coverage isn't cheap, and it isn't necessarily easy to get. And that gives me some concerns. But if you' re in business and you' re going to be operating at a fairly large scale, I think it has to be...it has to come to the point where it's a cost of doing business if you' re that large.

From: Janish, Tom
Workers' Compensation Agreement • April 14th, 2016
STROM & ASSOCIATES RECEIVES AGREEMENT IN FAVOR OF INJURED WORKER DROPPED BY WORKERS COMPENSATION INSURANCE
Workers Compensation Agreement • January 7th, 2005

CHICAGO – Rafael Esparza, a 25-year-old extruder operator, lost total use of his left arm after having it caught in an extruder at Viking Material in Chicago. After several operations, Esparza’s arm was saved but he never regained its full use. Upon returning to work, he quickly realized he was unable to perform his duties to the best of his abilities.

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