Request For Assignment Of Case Number

Form RACN - REQUEST FOR ASSIGNMENT OF CASE NUMBER. This form is used to request the assignment of a case number from the Office of the Judges of Compensation Claims in the State of Florida for various reasons, including settlement requiring approval by a judge, modification of a prior compensation order, claims for reimbursement from the Special Disability Trust Fund, third-party claims, claims limited to attorney's fees or taxable costs, and other specified reasons. The requester provides their name, title/capacity/client, contact information, as well as details about the employee, employer, and carrier involved in the case. Additionally, if the case involves additional parties, they must be clearly identified in the accompanying pleadings. The form also includes information about the collection and use of Social Security Numbers (SSNs) in compliance with privacy regulations. www.FormsWorkflow.com