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 - (Forms/Publications)
Document Information
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Title Application to Reopen Claim due to Worsening Condition - Spanish APLICACIÓN PARA REABRIR UN RECLAMO (A fillable form - 208 KB PDF)
Description

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 F242-079-909
Availability
Online only. See document above to download.
Keywords claim information, industrial insurance, occupational injuries, reopen, reopen claim, Reopening, worker's compensation, workers compensation, workers' compensation
Languages English/Spanish , English , Spanish
Valid dates 12-2012
Contact information

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