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Get Services Refusal Medical Treatment Injured 2021-2024

Ave been offered medical treatment by Name of injured worker my employer and advised of my right to file a workers compensation claim for my injury of but I have chosen to decline. I understand if I decide to seek Accident date medical attention at a later date, I must IMMEDIATELY contact the Work Comp Department at 310-440-9675 for further instructions BEFORE contacting a doctor. Signature of Injured Worker.

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Keywords relevant to Media Services Refusal Of Medical Treatment

  • contacting
  • declined
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