Third Party Action - State Fund
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
Third Party Action - State Fund (A fillable form - 443 KB PDF)
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|
| Description | Pamphlet/booklet: Summarizes the legal rights and options an injured worker has if a third-party action pertains to his/her workers' compensation claim. Includes the form that must be completed by the worker. Note: The form can be filled in using Adobe Reader, but must be printed, signed and mailed. | |
| Detail | ||
| Form number | F249-008-000 | |
| Availability | Order it |
|
| Keywords | espanol, injured worker, injury, spanish, third party | |
| Languages | English , Spanish | |
| Valid dates | 08-2012 | |
| Contact information | ||
| Web pages | Insurance for Business Injured by a Third Party? |
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