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State Form 51247 Application for Second Injury Fund Benefits - Indiana
What Is State Form 51247?
This is a legal form that was released by the Indiana Workers' Compensation Board - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the State Form 51247?
A: State Form 51247 is the Application for Second Injury Fund Benefits in Indiana.
Q: Who is eligible to apply for Second Injury Fund Benefits in Indiana?
A: Individuals who have suffered a second compensable injury and meet certain criteria may be eligible to apply for Second Injury Fund Benefits in Indiana.
Q: What is the purpose of the Second Injury Fund Benefits in Indiana?
A: The Second Injury Fund Benefits in Indiana provide additional compensation and support for individuals who have suffered a second compensable injury.
Q: What information is required in the State Form 51247?
A: The State Form 51247 Application for Second Injury Fund Benefits in Indiana requires specific information about the applicant's personal and employment details, previous injuries, and medical history.
Form Details:
- Released on March 1, 2022;
- The latest edition provided by the Indiana Workers' Compensation Board;
- 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 State Form 51247 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.
