Petition

PETITION. The Petition is the initiating document filed in the Nebraska Workers’ Compensation Court to formally begin a workers’ compensation claim. The form is completed by the injured employee (plaintiff) and alleges that an accident occurred during the course of employment, causing personal injury for which compensation is sought. It requires details such as the date and location of the accident, the employee’s job title, weekly wage, description of the injuries, and how the accident occurred. The petition must also state when and how the employer had notice of the accident. Additional sections identify the matters in dispute and request a hearing before the court to determine benefits under Nebraska law. A confidential section provides personal and financial account information, including Social Security or other identification numbers, which is kept private under court rules. www.FormsWorkflow.com