Application to Reopen Claim - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición

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Title Application to Reopen Claim - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición (A fillable form - 169 KB PDF)
Description

Benefits are limited to $50,000 per claim. if your claim has met or exceeded this cap, your reopening application will be denied and we will be unable to pay any further benefits. Used by victims of crime and medical or mental health providers to request a claim be reopened.
Detail
Form number F800-031-999
Availability
Not available in print
Keywords aggravation, condition, crime victims compensation, cvc, industrial insurance, worker's compensation, workers compensation, workers' compensation
Languages Spanish , English
Valid dates 12-2011
Contact information Crime Victims Compensation
Web pages Help for Crime Victims

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