Delaware
Workers Compensation
Last updated: 8/21/2023
Petition To Determine Disfigurement
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Description
PETITION TO DETERMINE DISFIGUREMENT. This form is used in Delaware to request a hearing from the Industrial Accident Board to determine if a claimant has sustained a compensable disfigurement due to a permanent industrial accident. It involves providing details about the claimant's name, the affected body part(s), and the accident date. The form concludes with the petitioner's name and date. www.FormsWorkflow.com
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