Michael F. Easley, Governor
Buck Lattimore, Chairman

Bernadine S. Ballance, Commissioner
Thomas J. Bolch, Commissioner
Laura K. Mavretic, Commissioner
Christopher Scott, Commissioner
Dianne C. Sellers, Commissioner
Pamela T. Young, Commissioner

North Carolina
Industrial Commission

 

IMPORTANT NOTICE

 

TO:         All Interested Parties

FROM:   Chairman Buck Lattimore

DATE:    September 16, 2005

RE:         New Form 25ACertification of Material Medical and Vocational Records (G.S. §97-82)

This new Form 25ACertification of Material Medical and Vocational Records (G.S. §97-82) will become effective October 1, 2005, as a result of changes in the law made by the General Assembly. Under the previous law, when submitting a Form 21 or 26 to the Industrial Commission for approval of a permanent partial disability rating, the parties were required to furnish and certify “all medical reports related to the injury which are known to exist.” The new law only requires the parties to furnish and certify the “material medical and vocational records” related to the injury.


Form 25ACertification of Material Medical and Vocational Records
(G.S. §97-82)
(revised 9/05)

Form 25ACertification of Material Medical and Vocational Records (G.S. §97-82),
Microsoft
® 2000 Document File with Form Fields (revised 9/05)


N.C. Industrial Commission · 4340 Mail Service Center · Raleigh, NC 27699-4340
Main Phone: (919) 807-2500 · Fax: (919) 715-0282
NCIC Home Page:
http://www.comp.state.nc.us/