Attorney Worksheet For Medicals Open Lump Sum Or Structured Where Medical Payments Will Continue | Pdf Fpdf Docx | Rhode Island

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Attorney Worksheet For Medicals Open Lump Sum Or Structured Where Medical Payments Will Continue | Pdf Fpdf Docx | Rhode Island

Last updated: 11/6/2025

Attorney Worksheet For Medicals Open Lump Sum Or Structured Where Medical Payments Will Continue

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Description

ATTORNEY WORKSHEET FOR "MEDICALS OPEN" LUMP SUM OR STRUCTURED-TYPE SETTLEMENTS WHERE MEDICAL PAYMENTS WILL CONTINUE.This form is a required filing in the Rhode Island Workers’ Compensation Court when a settlement is proposed but medical benefits will continue. This form gathers essential information about the petitioner, injury date, compensation rate, settlement details, Medicare Set-Aside (MSA) status, and counsel fees. Attorneys must certify that supporting documents—such as affidavits, medical statements, and settlement agreements—are attached. It ensures the court has full documentation for review while preserving ongoing medical payment obligations. www.FormsWorkflow.com

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