Worker Verification Form - Spanish Formulario de Verificación de Empleo

Worker Verification Form - Spanish Formulario de Verificación de Empleo - (Forms/Publications)
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Title Worker Verification Form - Spanish Formulario de Verificación de Empleo (A fillable form - 124 KB PDF)
Description

El trabajador lesionado debe completarlo si no puede trabajar debido a una lesión en el lugar de trabajo Y su empleador no le está pagando su salario completo.  

Detail
Form number F242-052-999
Availability
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Keywords beneficios, benefits, claims, cobertura, compensación, compensacion de los trabajadores, compensacion del trabajador, coverage, espanol, industrial insurance, lesiones, occupational injuries, ocupacionales, Pago, payment, Reclamo, salario, seguro, seguro industrial, spanish, tiempo perdido, time loss compensation, time-loss, verification, worker's compensation, workers compensation, workers' compensation
Languages Spanish , English
Valid dates 10-2008
Contact information Managing Injured Workers' Claims
Web pages Workers' Comp Claims

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