South Carolina > Workers Comp
Appellants Informal Brief 59 - South Carolina
| Appellants Informal Brief Form. This is a South Carolina form and can be used in Workers Comp . |
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WCC File #: South Carolina Workers' Compensation Commission 1333 Main Street, Suite 500 P.O. BOX 1715 Columbia, SC 29202-1715 (803) 737-5675 Carrier File #: Carrier Code #: Employer FEIN #: Claimant's Name: Address: City: Home Phone: Preparer's Name: ( ) State: Work Phone: SSN: - - Employer's Name: Address: Zip: ( ) - City: Insurance Carrier: Preparer's Phone #: ( ) State: Zip: 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? Do you feel there are any other reasons why the Commissioner's judgment was wrong? If so, what? What action do you want the Commission to take in this case? Signature Date (m/d/yyyy) IMPORTANT: A copy of this Brief and any attachments must be filed with the Commission within 10 days of receipt of the Review Hearing Notice, Form 31. The Commission will serve your Brief on the employer's representative. Questions about the use of this form may be directed to the Commission's Judicial Department. WCC Form # 59 Rev. 9/90 59 APPELLANT'S INFORMAL BRIEF American LegalNet, Inc. www.FormsWorkFlow.com
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