The Vermont Statutes Online
The Vermont Statutes Online have been updated to include the actions of the 2023 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
Title 21 : Labor
Chapter 009 : Employer's Liability and Workers' Compensation
(Cite as: 21 V.S.A. § 658)-
§ 658. Form of notice and claim
The notice and claim required under the provisions of section 656 of this title shall be in writing. Such notice shall contain the name and address of the employee, shall state in ordinary language the time, place, nature, and cause of the injury and shall be signed by the employee or by a person in his or her behalf, or, in the event of his or her death, by any one or more of his or her dependents or by a person in their behalf. The notice and the claim may be combined.
