Last updated: 2/8/2007
Notice Of Motion For Temporary And Or Medical Benefits {WC-101i}
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Description
WC-101 - NOTICE OF MOTION FOR TEMPORARY AND/OR MEDICAL BENEFITS (N.J.A.C. 12:235-3.2). This form is used in New Jersey Workers' Compensation cases by the petitioner (injured worker) to formally request temporary disability benefits or medical treatment related to a workplace injury. The petitioner claims entitlement to temporary disability payments due to being temporarily disabled and may also request medical treatment, diagnostic studies, or referral to a specialist. The motion is supported by affidavits, certifications, and medical reports. This form initiates a legal request for the court to order the respondent (employer or insurance carrier) to provide the requested benefits. www.FormsWorkflow.com
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