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This document is a decision from a contested case hearing regarding a workers' compensation appeal, addressing issues of compensability, injury date, and the claimant's failure to timely file a claim.
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How to fill out appeal no 013170
How to fill out APPEAL NO. 013170
01
Obtain APPEAL NO. 013170 form from the designated authority or website.
02
Read the instructions carefully before starting to fill out the form.
03
Enter your personal information in the specified fields, including your name, address, and contact information.
04
Provide details about the decision you are appealing, including the date and reference number.
05
Clearly state your reasons for the appeal in the designated section.
06
Attach any necessary supporting documents that substantiate your appeal.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form before submission.
09
Submit the completed APPEAL NO. 013170 form to the relevant office by the specified deadline.
Who needs APPEAL NO. 013170?
01
Individuals or organizations who have received an unfavorable decision and wish to contest it.
02
Parties affected by a ruling that they believe is unjust and want to seek reconsideration.
03
Anyone who has the legal standing to appeal based on the guidelines set forth in the governing regulations.
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What is APPEAL NO. 013170?
APPEAL NO. 013170 is a specific appeal process that allows individuals or entities to contest a decision made by an authority.
Who is required to file APPEAL NO. 013170?
Individuals or entities who are affected by a decision made by the relevant authority and wish to contest that decision are required to file APPEAL NO. 013170.
How to fill out APPEAL NO. 013170?
To fill out APPEAL NO. 013170, one must complete the designated form with accurate information, including details about the decision being appealed and any supporting documentation.
What is the purpose of APPEAL NO. 013170?
The purpose of APPEAL NO. 013170 is to provide a formal process for individuals or entities to challenge and seek a review of a decision made by an authority.
What information must be reported on APPEAL NO. 013170?
APPEAL NO. 013170 requires reporting information such as the appellant's details, the decision being appealed, reasons for the appeal, and any relevant supporting documents.
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