Form DOL-LM-112 Finger Amputation Impairment Form - South Dakota

What Is Form DOL-LM-112?

This is a legal form that was released by the South Dakota Department of Labor & Regulation - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DOL-LM-112 Finger Amputation Impairment Form?
A: The DOL-LM-112 Finger Amputation Impairment Form is a document used in South Dakota to determine the extent of impairment resulting from finger amputation.

Q: How is the DOL-LM-112 form used?
A: The DOL-LM-112 form is filled out by a medical professional to evaluate and document the loss of function or impairment caused by finger amputation.

Q: Who can fill out the DOL-LM-112 form?
A: The DOL-LM-112 form must be completed by a qualified medical professional such as a doctor or surgeon.

Q: What information is required on the DOL-LM-112 form?
A: The DOL-LM-112 form requires information about the individual's personal details, the date and cause of the finger amputation, as well as an assessment of the functional limitations caused by the amputation.

Q: Is the DOL-LM-112 form specific to South Dakota?
A: Yes, the DOL-LM-112 form is specific to South Dakota and is used within the state for workers' compensation and disability evaluation purposes.