Workers compensation benefits examiner
Found 4 free book(s)
Understanding Your Schedule Loss of Use Award
www.wcb.ny.govThe New York State Workers’ Compensation Board protects the rights of employees and employers by ensuring the proper delivery of benefits and by promoting compliance with the law. To learn more about the Board, visit wcb.ny.gov. QUESTIONS The Workers’ Compensation Board (Board) can help you understand your Schedule Loss of Use claim.
Claim for Compensation U.S. Department of Labor
www.dol.govOffice of Workers' Compensation Programs. Claim for Compensation. SECTION 1. EMPLOYEE PORTION. Middle. OMB No. 1240-0046 Expires: 05/31/2024 a. Name of Employee. Last First . b. Mailing Address ( Including City State, ZIP Code) c. OWCP File Number. d. Date of Injury e. Social Security Number. Month Day Year E-Mail Address (Optional ...
ECOMP - Electronic Document Submission
www.ecomp.dol.govWorkers' Compensation Programs, P. O. Box 37117, Washington, DC 20013-7117. A request for an appeal with the Employees’ ompensation Appeals oard should be addressed to: Employees' Compensation Appeals Board, 200 Constitution Ave NW, Room S-5220, Washington, DC 20210. Review any formal decision you may have
Duty Status Report U.S. Department of Labor
gacc.nifc.govWorkers' Compensation Programs, Room S-3229, 200 Constitution Avenue, NW, Washington, DC 20210, and reference the OMB Control Number 1240-0046. Note: Please do not send the completed form to this office. CA-17 PAGE 3 (Rev. 05-11)