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Get HI Hartford TDI-45 2011-2024

R employer. II. Answer all questions in Part A, Claimant’s Statement. Make sure you sign your name, or if you are unable to, have a responsible person sign for you. To avoid unnecessary delay, present your claim form to your employer, no later than 90 days after you are unable to perform the duties of your job. If you file beyond 90 days, att ach a statement explaining why you were unable to file earlier. After you file your claim, your employer or employer’s insurance carrier will notify yo.

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