Application to Reopen Claim due to Worsening Condition - Spanish APLICACIÓN PARA REABRIR UN RECLAMO


Application to Reopen Claim due to Worsening Condition - Spanish APLICACIÓN PARA REABRIR UN RECLAMO

Document Information
Get help downloading & printing files. How to complete a fillable form.
Title	Application to Reopen Claim due to Worsening Condition - Spanish APLICACIÓN PARA REABRIR UN RECLAMO (117 KB PDF)
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.
Detail
Form number	F242-079-999
Availability	Online only
Keywords	application, application to reopen, apply to reopen, claim closure, claim information, claims, doctor, industrial insurance, injured worker, injury, insurance, occupational, occupational injuries, reopen, reopen claim, spanish, worker's compensation, workers compensation, workers' compensation, worsening
Languages	Spanish , English
Valid dates	08-2007
Contact information	Claims for Job Injuries