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Form C-3 Employer's Report Of Industrial Injury or Occupational Disease. As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of an accident. Fatalities must be reported within 24 hours.
Report of Termination of Disabilty. and/or Payment. U.S. Department of Labor. Form CA-3.
OC-400 Reverse (12-21) It is unlawful to disclose individually identifiable information from Workers' Compensation Board records to any person who is not otherwise lawfully authorized to obtain these records.
EMPLOYEE'S CLAIM FOR COMPENSATION/REPORT OF INITIAL TREATMENT. FORM C-4.
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