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

Used by a totally permanently disabled worker. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of benefits.

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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