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FIASCO CORPORATION P.O. Box 516 * Nitro, WV 25143 * (304) 7553328 Toll Free (800) 6248288 * Fax (304) 7557153 www.vimasco.com SDS SAFETY DATA SHEET 16 Sections SECTION 1 CHEMICAL PRODUCT AND COMPANY
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Provide details about your employer, such as their name, address, and contact information.
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Fill in the date and time of your injury or illness that led to a workers' compensation claim.
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Describe the nature of your injury or illness in detail, including how it occurred, the body part affected, and any specific medical treatments or procedures undergone.
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If you received immediate medical attention, include the name and contact details of the medical professional or facility that treated you.
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Provide information about any witnesses to the incident, if applicable.
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Specify the medical expenses incurred as a result of the injury or illness, including consultations, medications, surgeries, or any other relevant costs.
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If you have lost wages due to the injury or illness, provide details of your regular work hours, rate of pay, and the duration of time you were unable to work.
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Who needs wc1type c:
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Employees who have suffered a work-related injury or illness and are seeking workers' compensation benefits.
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Healthcare professionals or medical facilities involved in the treatment and diagnosis of the injured or ill worker, as they may need to provide relevant information for the wc1type c form.
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What is wc1type c?
wc1type c is a form used for reporting certain information to the government.
Who is required to file wc1type c?
Employers are required to file wc1type c.
How to fill out wc1type c?
You can fill out wc1type c online or by mail with the required information.
What is the purpose of wc1type c?
The purpose of wc1type c is to report information about employees' wages and taxes.
What information must be reported on wc1type c?
Information such as employee wages, tips, and taxes withheld must be reported on wc1type c.
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