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Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony

State:
Wisconsin
Control #:
WI-SKU-2368
Format:
Word
Instant download
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Description

Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony is a form mandated by the Wisconsin Department of Workforce Development. It provides evidence of an injury or occupational illness suffered by an employee, in lieu of testimony from the injured worker. The report must be filled out by a “practitioner— – a healthcare provider who is licensed to practice medicine in Wisconsin, such as a doctor, nurse, or chiropractor. The practitioner must provide detailed information about the injury or illness, including the date of injury, the nature of the injury, the diagnosis, and the prognosis. The report is used to determine whether the injury or illness is work-related, and is used to determine the appropriate level of compensation. There are two types of Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony: 1. Wisconsin Practitioners Report On Accident: This report is used to provide evidence of an injury suffered by an employee due to an accident in the workplace. 2. Wisconsin Practitioners Report On Industrial Disease: This report is used to provide evidence of an injury or illness suffered by an employee due to a hazardous workplace condition.

Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony is a form mandated by the Wisconsin Department of Workforce Development. It provides evidence of an injury or occupational illness suffered by an employee, in lieu of testimony from the injured worker. The report must be filled out by a “practitioner— – a healthcare provider who is licensed to practice medicine in Wisconsin, such as a doctor, nurse, or chiropractor. The practitioner must provide detailed information about the injury or illness, including the date of injury, the nature of the injury, the diagnosis, and the prognosis. The report is used to determine whether the injury or illness is work-related, and is used to determine the appropriate level of compensation. There are two types of Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony: 1. Wisconsin Practitioners Report On Accident: This report is used to provide evidence of an injury suffered by an employee due to an accident in the workplace. 2. Wisconsin Practitioners Report On Industrial Disease: This report is used to provide evidence of an injury or illness suffered by an employee due to a hazardous workplace condition.

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Wisconsin Practitioners Report On Accident Or Industrial Disease In Lieu of Testimony