Msc4 workers: Fill out & sign online

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Click ‘Get Form’ to open the msc4 workers document in the editor.
Begin by entering the I.C. File Number, Carrier Number, and County at the top of the form. These details are essential for identifying your case.
In the 'Plaintiff' and 'Defendant' sections, clearly write the names of both parties involved in the mediation process.
Fill in the appearances section by providing the names, telephone numbers, addresses, and fax numbers of both Plaintiff’s and Defendant’s attorneys.
Select a DRC certified mediator by writing their name and contact information in the designated fields. Ensure that this mediator has agreed to serve.
Indicate the scheduled date for the mediation conference within 120 days of receiving your mediation order.
Finally, sign and date the form at the bottom to confirm its accuracy before submission.

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