Petition to Determine Compensation Due to Dependents of Deceased Employee | Pdf Fpdf Docx | Delaware

 Delaware   Workers Compensation 
Petition to Determine Compensation Due to Dependents of Deceased Employee | Pdf Fpdf Docx | Delaware

Last updated: 8/21/2023

Petition to Determine Compensation Due to Dependents of Deceased Employee

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Description

PETITION TO DETERMINE COMPENSATION DUE TO DEPENDENTS OF DECEASED EMPLOYEE. This form is used in Delaware to petition the Industrial Accident Board to determine compensation for dependents of a deceased employee when an agreement with the employer couldn't be reached. It involves providing details about the deceased employee, the accident, medical treatment, family members, and more. The form is submitted to the Board, requesting a hearing and decisions based on facts and the law. The form concludes with space for the dependent's signature and affirmation of accuracy. www.FormsWorkflow.com

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