Declaración de derechos para los beneficios de un trabajador totalmente discapacitado bajo las Leyes del Seguro Industrial


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Title Declaración de derechos para los beneficios de un trabajador totalmente discapacitado bajo las Leyes del Seguro Industrial
Description

Usado por un trabajador permanentemente y totalmente discapacitado.  Este formulario debe completarse, firmarse, notarizarse y devolverse a L&I dentro de 30 días para que los beneficios no sean interrumpidos.

Document number F242-173-944
How to get this document
Keywords claim information, claims, coverage, declaration, disability pension benefits, entitlement, industrial insurance, injured worker, injuries, injury, insurance, occupational injuries, pension disability benefits, social security offset, sso, worker's compensation, workers compensation, workers' compensation
Alt Language(s) English
Valid dates 11/2009
Contact information
Websites Workers' Comp Claims

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