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Pennsylvania Impairment Rating Determination Face Sheet - Workers'...

Pennsylvania Determination

Pennsylvania Impairment Rating Determination Face Sheet - Workers' Compensation

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Category:

Pennsylvania Workers Compensation - Ratings - Impairment

State:

Pennsylvania

Control #:

PA-LIBC767-WC

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Description

This is one of the official workers' compensation forms for the state of Pennsylvania.

Related Forms

View Pennsylvania Request for Physician to Perform Impairment Rating for Workers' Compensation
View Pennsylvania Impairment Rating Evaluation Appointment for Workers' Compensation

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