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Arkansas Notice to Employer / Notice to Employee (Form N)
SKU: FFAR185 |   E-mail this product to a friend
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ACA § 11-9-701: Notice to Employer by Employee
Employees are to complete this form and give it to the employer immediately.
The employer shall not be responsible for disability, medical, or other benefits prior to receipt of the employee’s notice of injury. This notice is the front side of Form N.
The foregoing shall not apply when an employee requires emergency medical treatment outside the employer’s normal business hours.
However, in that event, the employee shall give notice of injury to the employer on the employer’s next regular business day.
ACA §§ 11-9-508, 11-9-514: Notice to Employee by Employer
The employer may select the initial primary care physician from among those associated with a certified MCO.
Employees may request a CoP from the carrier or employer. If the request is denied, employees may send a petition to the Clerk of the AWCC for a one-time-only CoP.
If the employer / insurer fails to give or send a notice to the employee regarding CoP, then those regulations may not apply. This notice is the back side of Form N.
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