Stay at Work Wage Reimbursement Application for Employers

Stay at Work Wage Reimbursement Application for Employers - (Forms/Publications)
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Title Stay at Work Wage Reimbursement Application for Employers (155 KB DOC)
Description

Employer of record can request reimbursement for wages paid to an injured worker during light duty or transitional work. After completing the form, the employer submits it, along with supporting documentation, to the Stay at Work program for review and approval. For expense reimbursements see F243-003-000.

Detail
Form number F243-001-000
Availability
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Keywords claim, early, incentive, injury, job, payroll, return, subsidy
Languages English
Valid dates 05-2013
Contact information Stay at Work
Web pages Stay at Work

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