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ACTION: OriginalDATE: 11/02/2006 4:38 PMRule Summary and Fiscal Analysis (Part A) Bureau of Workers\' Compensation Agency NameTom Sico DivisionContact30 West Spring St. L26 Columbus OH 43215000061446666006144669384Agency
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What is 4123-3-10 amendment?
The 4123-3-10 amendment refers to a specific form used in workers' compensation cases to amend or update the information related to a claim, typically involving changes in the beneficiary, medical status, or other critical claim details.
Who is required to file 4123-3-10 amendment?
Employers, insurance carriers, or individuals responsible for a workers' compensation claim are required to file the 4123-3-10 amendment when there are changes or updates that need to be documented.
How to fill out 4123-3-10 amendment?
To fill out the 4123-3-10 amendment, obtain the form from the appropriate state workers' compensation board, fill in the required identifying information, detail the amendments being made, and provide any supporting documentation.
What is the purpose of 4123-3-10 amendment?
The purpose of the 4123-3-10 amendment is to ensure that all relevant information regarding a workers' compensation claim is accurate and up to date, thereby facilitating the proper administration of benefits.
What information must be reported on 4123-3-10 amendment?
The information that must be reported includes the claimant's details, the nature of the amendment, specific dates, and any changes related to medical treatment or beneficiary status.
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