Obtenga un formulario o publicación: permanent partial disability
Su búsqueda de "permanent partial disability" consiguió 18 resultados.
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| Título | Tipo | Número |
|---|---|---|
Notificación de Decisión de Cierre para Reclamos Únicamente Médicos para Empleadores Autoasegurados Also available in: English Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed with medical benefits only. This order is used only when neither time loss compensation nor a permanent partial disability award has been paid. |
Form | F207-020-999 |
| Doctor's Worksheet for Rating Dorso-Lumbar & Lumbo-Sacral Impairment
This worksheet is to help the attending physician perform impairment rating on their patients with permanent partial disability of the Dorso-Lumbar or Lumbo-Sacral spine. |
Form | F252-006-000 |
| Notificaci贸n de Decisi贸n de Cierre con Discapacidad Parcial Permanente para Empleadores Autoasegurados - PPD-NTL
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has not been paid, but a permanent partial disability award is being paid. |
Form | F207-165-999 |
| Notificaci贸n de Decisi贸n de Cierre con Discapacidad Parcial Permanente para Empleadores Autoasegurados - PPD-TL
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, and a permanent partial disability award is also being paid. |
Form | F207-164-999 |
| Notificaci贸n de Decisi贸n de Cierre para reclamos de Tiempo Perdido para Empleadores Autoasegurados
Also available in: English Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, but no permanent partial disability award is being paid. |
Form | F207-070-999 |
| Schedule of Future Payments for the Balance of the Permanent Partial Disability Award
Schedule of Future Payments for the Balance of the Permanent Partial Disability Award. |
Form | F207-162-000 |
| Self-Insured Employers' Medical Only Claim Closure Order and Notice
Also available in: Cambodian, Korean, Spanish Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed with medical benefits only. This order is used only when neither time loss compensation nor a permanent partial disability award has been paid. |
Form | F207-020-111 |
| Self-Insured Employers' Medical Only Claim Closure Order and Notice - Cambodian
Also available in: English Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed with medical benefits only. This order is used only when neither time loss compensation nor a permanent partial disability award has been paid. |
Form | F207-020-666 |
| Self-Insured Employers' Medical Only Claim Closure Order and Notice - Korean
Also available in: English Used by self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed with medical benefits only. This order is used only when neither time loss compensation nor a permanent partial disability award has been paid. |
Form | F207-020-777 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL
Also available in: Cambodian, Korean, Spanish Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has not been paid, but a permanent partial disability award is being paid. |
Form | F207-165-000 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL - Korean
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has not been paid, but a permanent partial disability award is being paid. |
Form | F207-165-777 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL -Cambodian
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has not been paid, but a permanent partial disability award is being paid. |
Form | F207-165-666 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-TL
Also available in: Cambodian, Korean, Spanish Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, and a permanent partial disability award is also being paid. |
Form | F207-164-000 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-TL - Cambodian
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, and a permanent partial disability award is also being paid. |
Form | F207-164-666 |
| Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-TL -Korean
Also available in: English Used by self-insured employers or their representatives only, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, and a permanent partial disability award is also being paid. |
Form | F207-164-777 |
| Self-Insured Employers' Time Loss Claim Closure Order and Notice
Also available in: Cambodian, Korean, Spanish Used by only self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, but no permanent partial disability award is being paid. |
Form | F207-070-000 |
| Self-Insured Employers' Time Loss Claim Closure Order and Notice - Korean
Also available in: English Used by only self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, but no permanent partial disability award is being paid. |
Form | F207-070-777 |
| Self-Insured Employers' Time Loss Claim Closure Order and Notice -Cambodian
Also available in: English Used by only self-insured employers or their representatives, this is legal notification to an injured worker that their claim is being closed. This order is used only when time loss compensation has been paid, but no permanent partial disability award is being paid. |
Form | F207-070-666 |
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