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Get TX DWC069 2015-2024

Compensable injury, based upon competent objective medical evidence that is independently confirmable by a doctor, including a designated doctor, without reliance on the subjective symptoms perceived by the employee. a) b) I certify that the employee does not have any permanent impairment as a result of the compensable injury. - OR I certify that the employee has permanent impairment as a result of the compensable injury. The amount of permanent impairment is _____%, which was determined in acc.

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