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Title 8 California Code of Regulations Chapter 4.5. Division of Workers' Compensation Subchapter 1. Administrative Director -- Administrative Rules Article 3.5. Medical Provider Networks Section 9767.1.

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Start by entering your personal information in the designated sections. This may include your name, address, contact information, and social security number.

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Proceed to provide details about your employment history, such as your current employer and job title. Include information about any previous employers you've had within a specified time frame.

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Who needs c000488 - Coventry Workers39:

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Employees who have suffered work-related injuries or developed work-related health conditions requiring medical treatment or compensation may need to fill out c000488 - Coventry Workers39. This form is often required by employers or insurance companies to initiate a workers' compensation claim.

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Employers or HR representatives may need to fill out this form on behalf of their employees who have experienced work-related injuries or conditions in order to initiate the workers' compensation process and provide necessary documentation.

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