Petition To Determine Additional Compensation Due To Injured Employee | Pdf Fpdf Doc Docx | Delaware

 Delaware   Workers Compensation 
Petition To Determine Additional Compensation Due To Injured Employee | Pdf Fpdf Doc Docx | Delaware

Last updated: 8/21/2023

Petition To Determine Additional Compensation Due To Injured Employee

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Description

PETITION TO DETERMINE ADDITIONAL COMPENSATION DUE TO INJURED EMPLOYEE. This form is used in Delaware to petition the Industrial Accident Board for additional compensation for an injured employee. It involves the claimant, employer, and carrier/self-insurer. The form requests the Board to hold a hearing and make decisions on various types of compensation, such as recurrence of disability benefits, permanent impairment, transportation expenses, and medical expenses. The petitioner's signature on the form authorizes the sharing of medical records. The form concludes with claimant details and space for signatures. www.FormsWorkflow.com

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