AK Form 5020 2025

AK Form 5020: What You Should Know

Do not sign until instructed to do so. 9. Complete the Employee's Claim for Loss or Damage in Case of Work-Related Injuries. 10. Complete a copy of the Medical and Other Statement of Benefits Form with the Claim form. Submit the claim form and other documents to both the employer and the Medical Review and Review Committee. Do NOT forward to the Medical Review and Review Committee until the Medical Review and Review Committee has written your claim or the medical records you have submitted are confirmed. 11. Complete the Employer's Notification of Occupational Injuries to Employees and the Required Medical Records. 12. Complete and send the Forms 5020 and Forms 5020-F (Employer's Notification) to the Department. It may take up to 15 days for approval by the Department. The Department will release your claim to you if and where the form has been approved as of the date a letter has been sent stating you have received it.   Claims to the Disability Compensation Fund — (Information on what to do during the waiting period for claims to the Commission) Income Tax Returns (Information on what to do if you have paid sales, etc.

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