Third Party Recovery Worksheet
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
Third Party Recovery Worksheet (A fillable form - 106 KB PDF)
|
|
| Description | Used by third party attorneys to calculate distribution of proposed settlements in third party claims. |
|
| Detail | ||
| Form number | F249-006-111 | |
| Availability | Online only. See document above to download. |
|
| Keywords | calculations, cost recovery, industrial insurance, worker's compensation, workers compensation, workers' compensation | |
| Languages | English | |
| Valid dates | 05-2000 | |
| Contact information |
Third Party Claim Cost Recovery
|
|
| Web pages | Workers' Comp Claims Injured by a Third Party? |
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