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Notificación de Lesiones de Compensación para Trabajadores - Enfermedad - Notification of Workers' Compensation Injury - Illness

State:
Multi-State
Control #:
US-294EM
Format:
Word
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Description

Este formulario se utiliza para informar a una empresa de compensación para trabajadores sobre una lesión o enfermedad sufrida por un empleado mientras estaba de servicio. Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
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Notificación de Lesiones de Compensación para Trabajadores - Enfermedad