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DIVISION OF TEMPORARY DISABILITY INSURANCE APPLICATION FOR FAMILY LEAVE INSURANCE BENEFITS (FL-1) DETACH THIS PAGE AND KEEP FOR YOUR RECORDS RULES FOR FILING A CLAIM AND APPEAL RIGHTS 1. It is your

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What is division of temporary disability?

Division of temporary disability refers to the process of dividing temporary disability benefits among multiple parties in a workers' compensation case.

Who is required to file division of temporary disability?

The injured worker or their representative is required to file division of temporary disability.

How to fill out division of temporary disability?

To fill out division of temporary disability, the injured worker must provide relevant information such as personal details, injury details, date of disability, and other relevant information as requested.

What is the purpose of division of temporary disability?

The purpose of division of temporary disability is to ensure that temporary disability benefits are allocated fairly among all parties involved in a workers' compensation case.

What information must be reported on division of temporary disability?

Information such as personal details, injury details, date of disability, medical treatment received, and any other relevant information must be reported on division of temporary disability.

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