FORM 18 - North Carolina Industrial Commission - NC.gov - nclm 2025

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The document is a Form 18 from the North Carolina Industrial Commission, which serves as a notice of accident and claim for workers' compensation. It outlines the necessary information required from an employee who has sustained an injury or occupational disease, including details about the incident, medical treatment, and employer information. The form must be filed within two years of the injury date and submitted to both the Industrial Commission and the employer to ensure legal claims are established and rights protected.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'I.C. File #' if you have it; otherwise, leave it blank as it will be assigned later.
Enter your personal information, including your name, address, and Social Security Number. Ensure accuracy for processing.
Provide details about your employer, including their name, address, and insurance carrier information. If unsure of the carrier, consult your employer or leave it blank.
Describe the injury or occupational disease clearly, including the date and time of occurrence. Specify the body part involved.
Indicate your occupation at the time of injury and how the incident occurred. This helps clarify your claim.
Complete additional fields regarding medical treatment received and days out of work due to injury.
Finally, sign the form either yourself or through a representative if you are unable to do so. Retain copies for your records before submission.

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What documents are needed with Form 18?

When completing a Form 18, it is essential to provide supporting documentation to strengthen the claim. This may include medical records, witness statements, incident reports, and any other relevant evidence.

What is form 18 in NC workers compensation?

A Form 18 establishes a legal claim of injury on your behalf if filed within two years of the date of injury or occupational disease, and gives the required written notice to the employer if a copy is submitted to the employer within 30 days of the injury.