Indiana Application for Second Injury Fund Benefits — SF 51247 is a form required by the Indiana Department of Workforce Development that employers must submit when filing a claim for Second Injury Fund benefits for injured workers. This form is used to document the employee's injury and the employer's potential liability for the injury. The form is divided into two parts: Part A is used to describe the injury and its severity, while Part B is used to document the employer's potential liability for the injury. There are two types of Indiana Application for Second Injury Fund Benefits — SF 51247, one for initial claims and one for supplemental claims.
Indiana Application for Second Injury Fund Benefits — SF 51247 is a form required by the Indiana Department of Workforce Development that employers must submit when filing a claim for Second Injury Fund benefits for injured workers. This form is used to document the employee's injury and the employer's potential liability for the injury. The form is divided into two parts: Part A is used to describe the injury and its severity, while Part B is used to document the employer's potential liability for the injury. There are two types of Indiana Application for Second Injury Fund Benefits — SF 51247, one for initial claims and one for supplemental claims.
