Hearing Impairment Calculation Worksheet

Hearing Impairment Calculation Worksheet - (Forms/Publications)
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Title   Hearing Impairment Calculation Worksheet (328 KB PDF)
Description Used by the attending doctor to determine hearing loss.
Detail
Form number F252-007-000
Availability
Online only. See document above to download.
Keywords hearing impairment, hearing loss
Languages English
Valid dates 09-2000
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Treating Injured Workers
Web pages Workers' Comp Claims
For Medical Providers

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