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Get Certificate Of Readiness Tennessee Form

://www.tn.gov/labor-wfd/wcomp.html Toll Free Help Line: 1-800-332-2667 STAMP- DATE RECEIVED RFA # This Certificate is to be filed ONLY if the Request for Benefit Review Conference Form C40B was previously filed. The BRC will not be scheduled if information marked by asterisks on this form is missing. * * Date of Injury: Employee s Social Security Number: A Request for Benefit Review Conference in this matter was previously filed with the Division on * The Employee has reached Maxim.

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