| Información del documento | ||
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| Título |
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| Descripción | Injured worker fills this out to document possible occupational disease and to show work history. | |
| Detalle | ||
| Número del formulario | F242-071-911 | |
| Disponibilidad | ordénelo | |
| Palabras claves | claim information, claims, diseases, employment history, industrial insurance, injury, medical, occupational diseases, occupational injuries, repetitive trauma, worker's compensation, workers compensation, workers' compensation | |
| Idiomas | Spanish, English | |
| Fechas válidas | 10-2005 | |
| Contacto |
Managing Injured Workers' Claims
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| Información relacionada | ||
| Documentos | Historial de Trabajo (Enfermedad Ocupacional) |
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| Páginas de Internet | Workers' Comp Claims | |