Appellants Informal Brief {59}

IMPORTANT: The Department WCC Form # 59Rev. 59 S outh C arolina 1333 Main Street, Suite 500 P.O. BOX 1715 Columbia, SC 29202 - 1715 (803) 737 - 5 675 WCC File #: Carrier File #: Carrier Code #: Employer FEIN #: Claimant's Name: SSN: Address: City: State: Zip: Home Phone: Work Phone: Employer's Name: Address: City: State: Zip: Insurance Carrier: Law Firm: DIRECTIONS: Please print or type. Answer the following questions about your claim to the best of your ability. If you cannot answer a question, leave it blank. Use additional sheets of paper, if necessary. Please use short statements. Questions Did the Commissioner fail to consider important reasons for award of compensation? If so, what reasons? Did the Commissioner incorrectly decide the facts? If so, what facts? Do you think the Commissioner applied the wrong law? If so, what law? What act ion do you want the Commission to take in this case? Signature Date American LegalNet, Inc. www.FormsWorkFlow.com