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WORKERS COMPENSATION We have agreed to treat you for a work compensation injury/ illness. Prior to treatment and or further treatment the following information is needed. Please note: ALL areas must
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Workers compensation is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment.
Employers are required to provide workers compensation insurance for their employees.
To fill out workers compensation, employers must report the details of the injury or illness, the affected employee, and any medical treatment provided.
The purpose of workers compensation is to provide financial support and medical care for employees who are injured or become ill while on the job.
Employers must report the date and time of the incident, the name of the injured employee, the nature of the injury, and any medical treatment provided.
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