Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición 

Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición  - (Forms/Publications)
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Title Application to Reopen Claim due to Worsening Condition - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición  (A fillable form - 208 KB PDF)
Description

Spanish version. Used by injured workers and doctors to apply to reopen an industrial injury or occupational disease claim that has been closed for longer than 60 days.

Detail
Form number F242-079-999
Availability
Online only. See document above to download.
Keywords claim closure, claim information, industrial insurance, occupational injuries, reopen, reopen claim, Reopening, worker's compensation, workers compensation, workers' compensation
Languages Spanish , English , English/Spanish
Valid dates 12-2012
Contact information Claims for Job Injuries

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