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Form LB-0030 (I-10; I-11; I-12) Notice of Waiver of Workers' Compensation Benefits for Specific Medical Conditions - Tennessee
What Is Form LB-0030 (I-10; I-11; I-12)?
This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form LB-0030?
A: Form LB-0030 is a Notice of Waiver of Workers' Compensation Benefits for Specific Medical Conditions in Tennessee.
Q: What does Form LB-0030 waive?
A: Form LB-0030 waives workers' compensation benefits for specific medical conditions.
Q: Who needs to fill out Form LB-0030?
A: Employees in Tennessee who wish to waive their workers' compensation benefits for specific medical conditions need to fill out Form LB-0030.
Q: What are the specific medical conditions covered by Form LB-0030?
A: The specific medical conditions covered by Form LB-0030 are listed in the form itself.
Form Details:
- Released on November 1, 2015;
- The latest edition provided by the Tennessee Department of Labor and Workforce Development;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form LB-0030 (I-10; I-11; I-12) by clicking the link below or browse more documents and templates provided by the Tennessee Department of Labor and Workforce Development.
