Fill and Sign the Request for Production of Documents to Carrier Form

BEFORE THE MISSISSIPPI WORKERS' COMPENSATION COMMISSION CLAIMANT VS. MWCC NO. EMPLOYER AND CARRIER REQUEST FOR PRODUCTION OF DOCUMENTS TO CARRIER TO THE DEFENDANT, TO ITS ATTORNEY OF RECORD: Pursuant to the rules of the Mississippi Workers' Compensation Commission, Claimant hereby requests you to produce and permit the inspection and copying of the following documents within thirty (30) days after receipt thereof by your attorneys at the office of counsel for located The term "documents" includes, but is not limited to, all handwritten, typed, printed and photostated matter, and drafts, duplicates, carbon copies or any other copy thereof, in the possession, custody or control of the Carrier or the counsel for the Employer and Carrier including without limiting the generality of the definition all letters, correspondence, memoranda, notes, reports, statements, paraphrases of statements, drawings, tape recordings, graphs and harts, printouts and computations, work papers, studies, agreements, contracts, and records of telephone calls in the possession, control or custody of the Carrier or its attorney. The manner of inspection shall be personal inspection including the copying and photographing by or on behalf of the Claimant the following mentioned documents, and other tangible things, not privileged. 1. The entire claim file of concerning . 2. Please produce a copy of each and every medical, hospital, drug or doctor's bill in your possession not previously provided to the Claimant incurred by Claimant in connection with the injuries and/or medical condition for which claim is made herein. 3. Please produce a copy of each and every medical report in your possession concerning Claimant, .4. Please produce a copy of each and every document filed by with the Mississippi Workers' Compensation Commission in connection with the injuries sustained by while an employee at . Respectfully submitted on this the day of , A. D., 20 . ATTORNEYS FOR THE CLAIMANT BY: CERTIFICATE OF SERVICE This is to certify that I, have this day furnished a true and correct copy of the above and foregoing Request For Production of Documents To Carrier to Hon. Attorney at Law, by placing same in the United States Mail, postage prepaid, and mailing to him at his usual office address. This the day of , A. D., 20 . ATTORNEYS FOR THE CLAIMANT BY: