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Form 3213 Occupational Disability Medical Report - Illinois
What Is Form 3213?
This is a legal form that was released by the Illinois State Employees Retirement System - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 3213 Occupational Disability Medical Report?
A: Form 3213 Occupational Disability Medical Report is a document used in Illinois to report occupational disabilities.
Q: Who is required to fill out Form 3213 Occupational Disability Medical Report?
A: Form 3213 Occupational Disability Medical Report is filled out by healthcare professionals when a person has a work-related injury or illness.
Q: What information is included in Form 3213 Occupational Disability Medical Report?
A: Form 3213 Occupational Disability Medical Report includes information about the injured/ill person's condition, treatment, work restrictions, and ability to perform job duties.
Q: Is Form 3213 Occupational Disability Medical Report used in any other states?
A: No, Form 3213 Occupational Disability Medical Report is specific to Illinois.
Form Details:
- Released on January 1, 2021;
- The latest edition provided by the Illinois State Employees Retirement System;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 3213 by clicking the link below or browse more documents and templates provided by the Illinois State Employees Retirement System.
