Claim By Employee Representative Or Dependent For Benefits For Lung Disease {18B}

FORM 18B - CLAIM BY EMPLOYEE, REPRESENTATIVE, OR DEPENDENT FOR BENEFITS FOR LUNG DISEASE. This is a required form under the Workers' Compensation Act for employees, their representatives, or dependents filing a claim for benefits due to lung disease caused by occupational exposure to harmful substances like cotton dust, silica, asbestos, or others. This form requires detailed information about the employee, their employment history, and specifics on the exposure to hazardous substances. It also requires a list of employers and treating physicians over the last 20 years and an authorization for medical records disclosure related to the lung disease. The form is then submitted to the Industrial Commission to initiate the claim process for compensation related to the occupational disease. www.FormsWorkflow.com