Compensation Injury Form

Pennsylvania Claim Petition for Additional Compensation from the Subsequent Injury Fund
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State:
Pennsylvania
Control #:
PA-LIBC375-WC
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Available formats: Adobe PDF

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Description Pennsylvania Claim

This form is an official Pennsylvania's Worker's Compensation form which complies with all applicable state codes and statutes. USLF updates all state forms as is required by state statutes and law.

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