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Board Rule 61b23 Form Wc108a Attorney Fee Approval

An attorney shall file this form in order to request approval of a fee contract, …

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Board Rule 61b22 Form Wc104 Notice To Employee Of Medical Release To Return To Work With Restrictions Or Limitations

For non-catastrophic accidents occurring on or after July 1, 1992, the employer/insurer shall send this …

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Board Rule 61b41 Form Wcchange Of Address Change Of Address

This form is to be used only to change certain addresses of record.  For employees, …

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Board Rule 61b22 Form Wc104

Notice To Employee Of Medical Release To Return To Work With Restrictions Or Limitations For …

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Board Rule 61b23 Form Wc108aattorney Fee Approval

An attorney shall file this form in order to request approval of a fee contract, …

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Board Rule 61b24 Form Wc108battorney Withdrawalattorney Fee Lien

An attorney who wishes to withdraw must file this form and follow the procedure set …

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Board Rule 61b25 Form Wc121change Of Tpa Claims Officeservicing Agent

An insurer, self-insurer, or self-insurance fund shall file this form to give: (1)  notice of …

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Board Rule 61b39 Form Wc244reimbursement Request Of Group Insurance Carrierdisability Benefits Provider

A group insurance carrier or disability benefits provider which requests reimbursement of disability benefits shall …

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Board Rule 61b11 Form Wc14a Request To Change Information On A Previously Filed Form Wc14

A party or attorney shall file this form with the Board when requesting correction of …

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