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Indiana Employee Waiver of Examination by Personal Physician - SF...

Indiana Employee Waiver of Examination by Personal Physician - SF 53913

Name: Indiana Employee Waiver of Examination by Personal Physician - SF 53913
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.68 (400 reviews)

Category:

Indiana Workers Compensation - Official - General

State:

Indiana

Control #:

IN-53913-WC

Format:

Instant download

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Description

Employee Waiver of Examination by Personal Physician - SF 53913 Indiana Employee Waiver of Examination by Personal Physician — SF 53913 is a form that must be completed and signed by an employee who is seeking a waiver of the requirement to have an examination by his or her personal physician. This form must be submitted to the Indiana Department of Workforce Development or the Occupational Safety and Health Administration (OSHA) in order to be considered for a waiver of the examination requirement. The form contains information about the employee, his or her medical history, and the reason for requesting the waiver. It also includes various signature lines and other relevant information. There are two types of Indiana Employee Waiver of Examination by Personal Physician — SF 53913: one for employees in the private sector, and one for state employees.

Indiana Employee Waiver of Examination by Personal Physician — SF 53913 is a form that must be completed and signed by an employee who is seeking a waiver of the requirement to have an examination by his or her personal physician. This form must be submitted to the Indiana Department of Workforce Development or the Occupational Safety and Health Administration (OSHA) in order to be considered for a waiver of the examination requirement. The form contains information about the employee, his or her medical history, and the reason for requesting the waiver. It also includes various signature lines and other relevant information. There are two types of Indiana Employee Waiver of Examination by Personal Physician — SF 53913: one for employees in the private sector, and one for state employees.

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How to fill out Indiana Employee Waiver Of Examination By Personal Physician - SF 53913?

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FAQ

You would need to bring a legal action against your employer or other responsible party. If you collect workers' compensation, you will lose the right to sue your employer. However, in Indiana, you cannot sue your employer for intentional or reckless bad actions. You can, however, sue a third party.

How to File a Workers' Compensation Claim in Indiana Step-by-step process for filing a workers' comp claim. Step #1: Seek medical attention. Step #2: Notify your employer. Step #3: Make certain your employer files the necessary form. Step #4: Wait to receive a decision from the insurance company.

You cannot be fired for any of the following: Discrimination against your race, color, sex, religion, national origin, age or disability. Retaliation for ?blowing the whistle? on illegal activity. Making a report of illegal discrimination or harassment. Requesting a disability accommodation.

In fact, if you are receiving workers' comp benefits for a workplace injury, you should be able to resign from your current job without losing benefits. Leaving a job doesn't automatically end a workers' comp claim.

A: An employer may not fire you for filing a workers compensation claim, but Indiana is an at-will employment state, meaning that an employee can be fired at any time except for a handful of reasons.

In Indiana employers are required to purchase workers' compensation coverage if they employ one or more workers. Sole Proprietors, Partners and LLC Members are all excluded from coverage, but have the option to be included. Corporate Officers are included in coverage, but may elect to included.

Form 29109: Application for Adjustment of Claim The form may be filed by an injured worker who believes that he is entitled to compensation or medical benefits. An employer who believes that compensation should be terminated may also file the form. This form is also used to attempt to re-open a settled claim.

How long you can collect workers' comp in Indiana depends on the type of benefits you qualify for and the severity of your injuries. The maximum amount of time to receive benefits is 500 weeks. Learn the factors that impact how long you can collect workers' compensation benefits and what to expect in the process.

More info

Download Fillable State Form 53913 In Pdf - The Latest Version Applicable For 2023. NOT complete the portion below.Medical Examination of Employees (cont.) 416.2.2.

Indiana Employee Waiver of Examination by Personal Physician - SF 53913

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