Get Department Of Labor Employees Compensation Appeals Board In The Matter Of Patrice Pettiway And U

Filling out the Department of Labor Employees Compensation Appeals Board form for the matter of Patrice Pettiway and U is a crucial step in seeking compensatory benefits. This guide will provide clear instructions to help users navigate the online completion of this important document.

Follow the steps to complete your form efficiently.

1. Click the ‘Get Form’ button to access the form and open it in your web browser.
2. Begin by entering your personal information at the top of the form. This typically includes your name, address, and contact details.
3. Fill out the details regarding the employment injury, including the date of the injury and the specific body part affected. In this case, enter the injury date as March 1, 1999, for left thumb tendinitis.
4. Provide information regarding your medical treatment. List the names of healthcare providers and dates of treatment, making sure to include relevant medical evidence to support your claim.
5. Indicate the periods of disability for which you are claiming compensation. Use the correct format to specify intermittent dates clearly, such as 'May 27 to June 14, 1999.'
6. Review the claim sections carefully, ensuring all information aligns with your medical documentation. Check for any additional documentation required.
7. Once all information has been correctly entered, save your changes and download a copy of the completed form for your records.
8. After reviewing your saved form, print it if needed or share it as instructed in the submission guidelines.

Complete your forms online to ensure a smooth claims process.