Can Form 18 be signed electronically?

Yes. Electronic signatures are generally valid under the ESIGN Act and UETA where applicable; ensure the signer consents to electronic records and the platform captures attribution and an audit trail.

Who must sign Form 18?

Typically the claimant or an authorized representative signs the form. If a representative signs, include a clear statement of authority or power of attorney documentation.

Where should I send the completed form?

Provide copies to the employer and insurer; follow North Carolina Industrial Commission filing procedures when an official filing with the Commission is required.

What supporting documents help a claim?

Attach medical reports, witness statements, and pay records as available. Early supporting documentation helps carriers evaluate entitlement and expedite benefits.

How do I correct errors after submission?

Contact the recipient employer or carrier immediately and provide a corrected form with a brief explanation. Maintain copies of both versions and communication records.

Is notarization required for Form 18?

Most Form 18 submissions do not require notarization. Check the Commission's filing instructions; certain affidavits or declarations may require notarization.

Electronic Signature
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Form 18 North Carolina Industrial Commission

Form 18 North Carolina Industrial Commission

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North Carolina Industrial Commission

NOTICE OF AWARD

IC File #

Emp. Code #

Employer FEIN

Carrier File #

Carrier Code #

The Use of This Form Is Required Under the Provisions of the Workers' Compensation Act.

Employee's Name

Employer's Name

Telephone Number

Address

Employer's Address

City

State

Zip

Insurance Carrier

Home Telephone

Work Telephone

Carrier's Address

Last 4 Digits of SSN

M F Sex

Date of Birth

City

State

Zip

Carrier's Telephone Number

Fax Number

The above parties have previously submitted an agreement for compensation for disability or death on Form . The

Commission entered an award in the case upon receipt of the agreement. The Commission has now been informed that

Therefore, the original award is amended as follows:

As above mentioned, said Agreement is hereby approved. This is a formal award of the Industrial Commission. Any interested party may give notice of appeal therefrom within fifteen (15) days or receipt of this award.

SIGNATURE

TITLE

DATE

FORM 30A

02/2017

PAGE 1 OF 1

FORM 30A

FILE VIA ELECTRONIC DOCUMENT FILING PORTAL

HTTP://WWW.IC.NC.GOV/DOCFILING.HTML

CONTACT INFORMATION:

NCIC-CLAIMS ADMINISTRATION

TELEPHONE: (919) 807-2502

HELPLINE: (800) 688-8349

WEBSITE: HTTP://WWW.IC.NC.GOV

What the Form 18 North Carolina Industrial Commission is

Form 18 North Carolina Industrial Commission is the standard workers' compensation claim form used in North Carolina to notify an employer and the Industrial Commission of a work-related injury or occupational disease. It records claimant and employer details, injury date and description, medical treatment received, and initial wage and employment information. Completing and submitting Form 18 initiates the administrative claim process with the Commission and informs the employer/carrier so the injury can be investigated, benefits evaluated, and the statutory record established for any later hearings or settlement discussions.

Why completing Form 18 properly matters

Accurate Form 18 completion preserves rights, starts claims processing, and creates an official record for benefits and hearings. It also helps the employer and insurer assess liability and arrange timely medical care and payment.

Who completes and relies on Form 18

Typical users prepare, sign, or receive Form 18 during the early stages of a workers' compensation matter.

Injured worker or claimant — provides personal, employment, and injury details for the claim record.
Employer or human resources — records incident, forwards to carrier, and documents wage and hiring facts.
Insurance adjuster or defense counsel — uses the form to open a claim file and begin investigation.

All parties rely on the form for timely benefits, correct claims handling, and to support any subsequent hearings or settlements.

Step-by-step: completing and submitting Form 18

Follow a clear sequence to collect facts, complete the form, get signatures, and route to the correct recipients.

01

Gather information: Collect claimant ID, employer details, injury date, and witness names before starting.
02

Complete form: Enter required fields legibly; use MM/DD/YYYY for dates and full addresses.
03

Sign: Claimant or authorized representative signs and dates the form in the designated block.
04

Submit: Provide copies to employer, insurer, and retain an original for your records.

Digital filing workflow for Form 18

When submitting electronically, follow a standard flow: upload the PDF, add fields, authenticate the signer, and archive with audit trail.

Upload document: Start with a clear PDF of Form 18 or a digitized version of the original.
Place fields: Add name, date, signature, and attachment fields where the form requires them.
Authenticate signer: Use email verification or stronger methods like SMS code for signer attribution.
Store copy: Save the signed PDF with an audit trail for later reference and compliance.

Recommended digital workflow settings for Form 18

Configure a repeatable workflow to reduce errors and enforce required fields for every submission.

Field	Configuration
Document format	Use PDF/A or flattened PDF for consistent rendering
Required fields	Enforce claimant name, injury date, and signature
Authentication	Email verification plus optional SMS code
Routing order	Claimant → Employer → Insurer/Carrier

Technical requirements for eSubmission platforms

Choose a platform that supports PDF, secure storage, and an auditable signature trail for legal defensibility.

File formats: PDF, DOCX supported
Integrations: Connects with NetSuite and Google Workspace
Security: AES-256 at rest

Timing expectations and filing considerations

Timely reporting and filing protect benefits. Specific deadlines vary by jurisdiction and case facts, so submit promptly after the injury is known.

Report to employer:

Notify employer as soon as possible to preserve claim rights.

File with Commission:

Submit Form 18 according to NCIC procedures or employer instructions.

Seek medical care:

Obtain initial treatment immediately and document dates and providers.

Retain copies:

Keep a signed original and stamped or digital receipt.

Follow insurer requests:

Provide requested documentation promptly to prevent delays.

Key milestones in the Form 18 lifecycle

Track four core milestones from injury to Commission review to stay compliant and informed.

01

Injury Occurs

Make immediate medical and employer notifications.

02

Form Preparation

Gather facts and complete Form 18 accurately.

03

Submission

Send to employer and carrier; file with the Commission when required.

04

Recordkeeping

Archive the signed form and supporting documents securely.

Security and compliance controls to protect Form 18 data

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Audit trail: Full tamper-evident signing log

Access controls: Role-based permissions and SSO

HIPAA readiness: BAA available where PHI is present

21 CFR Part 11: Support for FDA-regulated record controls

Certifications: SOC 2 Type II and ISO 27001

Common risks and consequences of errors on Form 18

Late reporting: May jeopardize benefit eligibility or delay payments

Incorrect date: Can create disputes about compensability

Missing signature: Submission may be rejected or deemed incomplete

Incomplete employer info: Slows carrier investigation and benefit decisions

Unsecured PII: Increases regulatory and privacy exposure

Improper service: Fails to notify required parties, causing procedural issues

eSignature vendor pricing snapshot relevant to Form 18 e-submission

Compare common eSignature options for secure Form 18 workflows. Pricing and feature availability vary by plan and billing term; confirm with each vendor before purchase.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently asked questions about Form 18 and e-submission

Answers to common procedural and technical questions about filling, signing, and submitting Form 18 for North Carolina workers' compensation claims.

Need help? Contact support

Can Form 18 be signed electronically?
Yes. Electronic signatures are generally valid under the ESIGN Act and UETA where applicable; ensure the signer consents to electronic records and the platform captures attribution and an audit trail.
Who must sign Form 18?
Typically the claimant or an authorized representative signs the form. If a representative signs, include a clear statement of authority or power of attorney documentation.
Where should I send the completed form?
Provide copies to the employer and insurer; follow North Carolina Industrial Commission filing procedures when an official filing with the Commission is required.
What supporting documents help a claim?
Attach medical reports, witness statements, and pay records as available. Early supporting documentation helps carriers evaluate entitlement and expedite benefits.
How do I correct errors after submission?
Contact the recipient employer or carrier immediately and provide a corrected form with a brief explanation. Maintain copies of both versions and communication records.
Is notarization required for Form 18?
Most Form 18 submissions do not require notarization. Check the Commission's filing instructions; certain affidavits or declarations may require notarization.

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