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Get the free Form C-4.3 - Workers' Compensation Board

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RESIDUAL FUNCTIONAL CAPACITY CERVICAL SPINE Name: Claim #: Date of Injury: Please Print Name of Medical Evaluator: Medical Specialty: Has any medication necessary to relieve and/or control pain and/or
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Fill in your personal details such as name, address, contact information, and social security number.
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Provide information about your employment history, including the names of employers, dates of employment, job titles, and responsibilities.
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Form C-43 - Workers is a document used to report information about workers including their wages, hours worked, and other related details.
Employers who have hired workers and need to report their information are required to file Form C-43 - Workers.
Form C-43 - Workers can be filled out manually or electronically by entering all the required information about the workers and their earnings.
The purpose of Form C-43 - Workers is to provide accurate information about workers to ensure compliance with labor laws and regulations.
Form C-43 - Workers requires information such as worker's name, social security number, wages earned, hours worked, and any deductions.
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