Informe de Lesion o Enfermedad Ocupacional


Informe de Lesion o Enfermedad Ocupacional - Hoja de Referencia

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Title	Informe de Lesion o Enfermedad Ocupacional - Hoja de Referencia (236 KB PDF)
Description	Used by Spanish-speaking injured worker who is filing a workers' compensation claim for an industrial injury or occupational disease. This form provides instructions in Spanish for completing the F242-130-000 Report of Industrial Injury or Occupational Disease. Available in L&I warehouse August 1.
Detail
Form number	F242-130-999
Availability	Order it
Keywords	report, report of accident, spanish
Languages	Spanish , English
Valid dates	05-2008
Contact information	Managing Injured Workers' Claims
Web pages	Workers' Comp Claims