PDF
Word
Form DA WC4000 Transitional Duty Employment Audit Form - Louisiana
What Is Form DA WC4000?
This is a legal form that was released by the Louisiana Division of Administration - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form DA WC4000?
A: The Form DA WC4000 is the Transitional Duty Employment Audit Form for Louisiana.
Q: What is the purpose of the Form DA WC4000?
A: The purpose of the Form DA WC4000 is to conduct an audit of transitional duty employment in Louisiana.
Q: Who uses the Form DA WC4000?
A: Employers, insurance carriers, and third-party administrators in Louisiana use the Form DA WC4000.
Q: What information is required on the Form DA WC4000?
A: The Form DA WC4000 requires information about the injured employee, the transitional duty job, and the dates and duration of the transitional duty employment.
Form Details:
- Released on June 1, 2020;
- The latest edition provided by the Louisiana Division of Administration;
- 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 printable version of Form DA WC4000 by clicking the link below or browse more documents and templates provided by the Louisiana Division of Administration.
