Notificación de Decisión de Cierre para reclamos Únicamente Médicos para Empleadores Autoasegurados


Notificación de Decisión de Cierre para reclamos Únicamente Médicos para Empleadores Autoasegurados

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Title	Notificación de Decisión de Cierre para reclamos Únicamente Médicos para Empleadores Autoasegurados (A fillable form - 101 KB PDF)
Description	Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed with medical benefits only. This order is used only when neither time loss compensation nor a permanent partial disability award has been paid.
Detail
Form number	F207-020-999
Availability	Online only
Keywords	benefits, claim information, claims, closure, espanol, industrial insurance, injured worker, injuries, injury, insurance, medical, medical only, self insurance, self insurer, self-insurance, self-insurer, spanish, time loss, time loss compensation, time-loss, time-loss compensation, worker's compensation, workers compensation, workers' compensation
Languages	Spanish , English
Valid dates	All dates valid
Contact information	Managing Injured Workers' Claims Claims for Job Injuries Self-Insurance
Related information
Documents	Notificación de Decisión de Cierre para reclamos de Tiempo Perdido para Empleadores Autoasegurados Notificación de Decisión de Cierre con Discapacidad Parcial Permanente para Empleadores Autoasegurados - PPD-TL Notificación de Decisión de Cierre con Discapacidad Parcial Permanente para Empleadores Autoasegurados - PPD-NTL
Web pages	Self-Insured Employers Insurance for Business