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This document is a decision by the Employees’ Compensation Appeals Board regarding the appeal filed by Jackie N. Lucas against the U.S. Postal Service concerning her workers' compensation claim.

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1. Start by reading the form instructions carefully to understand the purpose and requirements.
2. Provide your personal information such as name, address, and contact details in the designated fields.
3. Fill in the relevant sections related to your employment, including your employer's name, address, and identification number.
4. Indicate the type of work and occupation you are engaged in, along with the dates of employment.
5. If applicable, provide information about any previous work that could potentially affect your eligibility or benefit amount.
6. Read the certification statements and sign the form accordingly, acknowledging the accuracy and truthfulness of the information provided.
7. Keep a copy of the completed form for your records before submitting it to the appropriate authority.

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1. Individuals who are applying for or requesting specific benefits or services from the Department of Labor (DOL) may need to fill out the 03-2204doc form.
2. Employers who are required to report certain information about their employees or comply with DOL regulations may also need to use this form.
3. Additionally, individuals who are involved in legal proceedings or investigations related to labor issues may be required to fill out this form as part of the documentation process.

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03-2204doc - dol is a specific document used for reporting certain information to the Department of Labor (DOL).

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