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Claims Forms for Employees
Claims Forms for Employees
ServiceLloyds
2017-10-09T19:49:08-05:00
TDI Forms
DWC-32: Request for Designated Doctor
DWC-41: Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease
DWC-48: Request for Travel Reimbursement
DWC-51: Employee’s Election for Commuted (Lump Sum) Impairment Income Benefits
DWC-52: Application for Supplemental Income Benefits
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