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Get the free ISSUE STATEMENT: (Block 15)

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U.S. Department of LaborLeave Buy Back (LBB) Worksheet/ Certification and ElectionOffice of Workers Compensation ProgramsEmployee Statement Please carefully read instructions on pages 3 and 4 before
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Issue statement block 15 is a section on a form where a specific problem or concern is addressed.
The party responsible for the specific issue or concern described in block 15 is required to file the issue statement.
To fill out issue statement block 15, describe the issue or concern in detail, provide any relevant background information, and suggest potential solutions.
The purpose of issue statement block 15 is to clearly outline a specific problem or concern for further action or resolution.
The information reported on issue statement block 15 must include a clear description of the issue, any supporting evidence, and proposed solutions or actions.
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