Forms for Applying for NC Workers' Compensation

Mike Lewis Attorneys is dedicated to helping injured workers across North Carolina get the compensation they truly deserve.

Every on-the-job accident is unique, and your needs as an individual aren’t the same as every other injured employee. That’s why we approach each client with personal attention, and build a robust case on your behalf in order to get the most out of your claim.

Download Center: North Carolina Workers’ Compensation Forms

We’re here to simplify your workers’ compensation claim. Whether you’re just getting started or are looking to apply for additional compensation, appoint a guardian ad litem, or need to itemize statements, we have all of the NC workers’ compensation forms for claimants available for download.

Click on a form below to download:

Form 18A

Notice of Accident to Employer and Claim of Employee

This is your initial claim form, including instructions.

18a

Form 25T

Itemized Statement of Travel Charges

Itemize the costs of your travel expenses for medical treatment using this form.

25t

Form 18B

Claim for Lung Disease, Including Asbestosis, Silicosis and Byssinosis

Use this form for lung disease workers’ compensation claims

18b

Form 31

Application for Lump Sum Award

Use this form to apply to receive your workers’ comp benefits in one lump sum.

31

Form 18M

Employee’s Application for Additional Medical Compensation

Apply for more medical compensation using this form.

18m

Form 33

Request that Claim be assigned for Hearing

If there is a dispute with your claim and you wish to request a hearing, use this form.

33

Form 25P

Itemized Statement of charges for Drugs

Itemize the costs of your prescription drugs for your claim using this form.

25p

Form 42

Application for Appointment of Guardian Ad Litem

Use this form to apply to appoint a guardian ad litem for an infant or incompetent person.

42

Strengthen Your Workers’ Comp Claim with Mike Lewis Attorneys

You shouldn’t suffer the financial burden of medical bills and lost wages when your injury wasn’t your fault.

We’re here to help you. Find out about your legal options, learn about filing a claim, and get answers to your questions about hiring a workers’ comp lawyer, all for free during your case evaluation.

Start Your Free Case Evaluation Now:
Contact us online or call 866-299-1769.