Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición
See also
| Document Information | ||
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 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
 Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición (160 KB PDF)
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| Description | Spanish version. Used by injured workers and doctors to apply to reopen an industrial injury or occupational disease claim that has been closed for longer than 60 days. |
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| Detail | ||
| Form number | F242-079-999 | |
| Availability | Online only. See document above to download. |
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| Keywords | claim closure, claim information, industrial insurance, occupational injuries, reopen, reopen claim, Reopening, worker's compensation, workers compensation, workers' compensation | |
| Languages | Spanish , English , English/Spanish | |
| Valid dates | 12-2012 | |
| Contact information |
Claims for Job Injuries
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