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Reporting a Claim, Medical Treatment and Follow-up
Immediately report the injury to the Sedgwick workers compensation injury report line at 877-6UC-RPRT (877-682-7778) and your local workers compensation
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Workers Compensation Claim Form (DWC 1) Notice of
Jan 1, 2016 To file a claim, complete the Employee section of the form, keep one copy and give the rest to your employer. Do this right away to avoid
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Form CA-16 - Authorization for Examination / Medical
Send one copy of your report: (Fill in remainder of address). U.S. DEPARTMENT OF LABOR. Employment Standards Administration. Office of Workers Compensation
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