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Get OR Form 827 2012

Irst report of injury or disease • Request for acceptance of a new or omitted medical condition “Omitted” refers to a condition the worker thinks should have been included among the conditions accepted by the insurer. • Report of aggravation of original injury “Aggravation” means the actual worsening of an accepted condition resulting from the original injury. • Notice of change of attending physician or nurse practitioner This means the new provider will be primarily responsib.

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