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Get Multi-Specialty Health Care Loss of Enjoyment/Duties Under Duress Summary

S) affect your performance of your living and work duties. Place a check in front of the day-to-day living or work duties that are painful or difficult for you to perform as a result of the injuries you sustained. Then check mark the appropriate box designating reason for difficulty. Include those duties/responsibilities, which require that you reduce the time you are capable of performing them. Please Print Clearly in Black Ink Job description: _________________________________________________.

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