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Form LS-9 Stipulation Approval Request PDF DOCX

Form LS-9 Stipulation Approval Request

This Form is used for requesting approval for a stipulation agreement.

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Form OWCP-1168 Provider Enrollment Form PDF DOCX

Form OWCP-1168 Provider Enrollment Form
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Form CA-721 Notice of Law Enforcement Officer's Injury or Occupational Disease PDF DOCX

Form CA-721 Notice of Law Enforcement Officer's Injury or Occupational Disease
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Form CM-981 Certification by School Official PDF DOCX

Form CM-981 Certification by School Official
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Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act PDF DOCX

Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
Legal United States Legal Forms Expense Claim Form Insurance Claim Form Workers Compensation Forms U.S. Department of Labor United States Federal Legal Forms Government Benefits Claim for Reimbursement Benefit Payments
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Form CA-17 Duty Status Report PDF DOCX

Form CA-17 Duty Status Report
Legal Injury Report Form United States Legal Forms Workers Compensation Forms U.S. Department of Labor United States Federal Legal Forms Work Related Injury
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Form CA-7 Claim for Compensation PDF DOCX

Form CA-7 Claim for Compensation
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Form CA-20 Attending Physician's Report PDF DOCX

Form CA-20 Attending Physician's Report
Legal United States Legal Forms Health Assessment Form Physician Report Form U.S. Department of Labor United States Federal Legal Forms Doctor Report
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Form OWCP-5A Work Capacity Evaluation Psychiatric/Psychological Conditions PDF DOCX

Form OWCP-5A Work Capacity Evaluation Psychiatric/Psychological Conditions
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Form OWCP-5C Work Capacity Evaluation Musculoskeletal Conditions PDF DOCX

Form OWCP-5C Work Capacity Evaluation Musculoskeletal Conditions
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Form OWCP-5B Work Capacity Evaluation Cardiovascular/Pulmonary Conditions PDF DOCX

Form OWCP-5B Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
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Form CM-972 Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor PDF DOCX

Form CM-972 Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor
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Form CA-722 Notice of Law Enforcement Officer's Death PDF DOCX

Form CA-722 Notice of Law Enforcement Officer's Death
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Form CM-933 Radiologic Interpretation PDF DOCX

Form CM-933 Radiologic Interpretation
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Form LS-271 Application for Self-insurance PDF DOCX

Form LS-271 Application for Self-insurance
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Form LS-272 Application to Write Longshore Insurance PDF DOCX

Form LS-272 Application to Write Longshore Insurance
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Form LS-262 Claim for Death Benefits PDF DOCX

Form LS-262 Claim for Death Benefits
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Form LS-204 Attending Physician's Supplementary Report PDF DOCX

Form LS-204 Attending Physician's Supplementary Report
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Form LS-266 Application for Continuation of Death Benefit for Student PDF DOCX

Form LS-266 Application for Continuation of Death Benefit for Student
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Form LS-203 Employee's Claim for Compensation PDF DOCX

Form LS-203 Employee's Claim for Compensation
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Form LS-267 Claimant's Statement PDF DOCX

Form LS-267 Claimant's Statement
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Form LS-265 Certification of Funeral Expenses PDF DOCX

Form LS-265 Certification of Funeral Expenses
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Form LS-274 Report of Injury Experience of Insurance Carrier or Self-insured Employer PDF DOCX

Form LS-274 Report of Injury Experience of Insurance Carrier or Self-insured Employer
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Form LS-200 Report of Earnings PDF DOCX

Form LS-200 Report of Earnings
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Form LS-513 Report of Payments PDF DOCX

Form LS-513 Report of Payments
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Form LS-1 Request for Examination and/or Treatment PDF DOCX

Form LS-1 Request for Examination and/or Treatment
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Form LS-201 Notice of Employee's Injury or Death PDF DOCX

Form LS-201 Notice of Employee's Injury or Death
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Form CA-2A Notice of Recurrence PDF DOCX

Form CA-2A Notice of Recurrence
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Form LS-18 Pre-hearing Statement PDF DOCX

Form LS-18 Pre-hearing Statement
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Form OWCP-16 Rehabilitation Plan and Award PDF DOCX

Form OWCP-16 Rehabilitation Plan and Award
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Form CA-12 Claim for Continuance of Compensation Under the Federal Employees' Compensation Act PDF DOCX

Form CA-12 Claim for Continuance of Compensation Under the Federal Employees' Compensation Act
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Form CA-40 Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment Under 5 U.s.c. 8102a PDF DOCX

Form CA-40 Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment Under 5 U.s.c. 8102a
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Form CA-1031 Letter to Dependants to Verify Claimant Support PDF DOCX

Form CA-1031 Letter to Dependants to Verify Claimant Support
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Form OWCP-957 Part B Medical Travel Refund Request - Expenses PDF

Form OWCP-957 Part B Medical Travel Refund Request - Expenses
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Form CA-5 Claim for Compensation by Surviving Spouse and/or Children PDF

Form CA-5 Claim for Compensation by Surviving Spouse and/or Children
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Form CA-42 Official Notice of Employees' Death for Purposes of Feca Section 8102a Death Gratuit PDF DOCX

Form CA-42 Official Notice of Employees' Death for Purposes of Feca Section 8102a Death Gratuit
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Form CA-5B Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren PDF DOCX

Form CA-5B Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren
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Form CA-1074 Letter to Parents in Death Claim Development PDF DOCX

Form CA-1074 Letter to Parents in Death Claim Development
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