Attorney Worksheet For Lump Sum Or Structured-Type Settlements | Pdf Fpdf Doc Docx | Rhode Island

 Rhode Island   Workers Comp   Workers Compensation Court 
Attorney Worksheet For Lump Sum Or Structured-Type Settlements | Pdf Fpdf Doc Docx | Rhode Island

Last updated: 11/6/2025

Attorney Worksheet For Lump Sum Or Structured-Type Settlements

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Description

ATTORNEY WORKSHEET FOR LUMP SUM OR STRUCTURED-TYPE SETTLEMENTS.This form is used in the Rhode Island Workers’ Compensation Court to document settlement details in workers’ compensation cases. Attorneys must complete this form when submitting a petition for approval of either a lump sum or structured settlement. The worksheet collects key case data, including the petitioner’s name, date of injury, compensation rate, Medicare Set-Aside (MSA) status, settlement amount, and applicable counsel fees. It also certifies that required supporting documents are attached, such as medical statements, affidavits, and settlement agreements. www.FormsWorkflow.com

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