Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL

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Title Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL (A fillable form - 65 KB PDF)
Description Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has not been paid, but a permanent partial disability award is being paid.
Detail
Form number F207-165-000
Availability
Online only. See document above to download.
Keywords claim closure, claim information, claims, industrial insurance, injuries, injury, self insurance, self insurer, self-insurance, self-insurer, worker's compensation, workers compensation, workers' compensation
Languages English , Cambodian , Korean , Spanish
Valid dates All dates valid
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Self-Insurance
Related information
Documents Self-Insured Employers' Medical Only Claim Closure Order and Notice
Self-Insured Employers' Time Loss Claim Closure Order and Notice
Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-TL
Web pages Self-Insured Employers
Insurance for Business

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