Employees Notice Of Claim For Benefits From The Multiple Injury Trust Fund {CC-Form-3F}

CC-FORM-3F - EMPLOYEE’S NOTICE OF CLAIM FOR BENEFITS FROM THE MULTIPLE INJURY TRUST FUND. This form is used by employees in Oklahoma when they have suffered a subsequent injury on or after February 1, 2014. This form is essential for workers who have pre-existing disabilities and have sustained a new workplace injury that has resulted in additional disability. The Multiple Injury Trust Fund (MITF) provides compensation when the combined effect of a prior disability and a subsequent workplace injury results in a greater level of impairment than the latest injury alone. The form requires the claimant to provide personal information, details of their most recent workplace injury, prior workers' compensation awards, and any obvious and apparent pre-existing disabilities that were not previously compensated. The claimant must specify whether they are still receiving weekly benefits for any past awards. www.FormsWorkflow.com