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The consent shall not be executed prior to the occurrence of employee's work-related injury or illness, but must be executed prior to an employer, who is not part of a PPO or ADR program, recommending a network or provider to an injured employee for treatment purposes.

When an injured worker is requesting a redetermination due to an extreme hardship as described in Section 35(3) of the Workers' Compensation Law and has been classified with a permanent partial disability with a loss of wage earning capacity of greater than 75% and capped benefits will expire within one year.

Formularz oraz wszystkie dokumenty wspierające działania w zakresie poszukiwania pracy muszą zostać przesłane do Komisji przed rozprawą lub przyniesione w dniu rozprawy w celu przekazania sędzi ds. Miejsce i termin złożenia tego formularza określono w szczegółowej instrukcji na stronie drugiej formularza.

Ten formularz służy do dokumentacji wysiłków podjętych w celu znalezienia pracy z uwzględnieniem ograniczeń medycznych wnioskodawcy oraz z pomocą agencji lub doradcy ds.

Questo modulo e tutti i documenti a supporto delle dichiarazioni relative all’impegno profuso nella ricerca di un impiego devono essere inviati al Comitato prima dell’udienza, o portati con sé nel giorno dell’udienza e consegnati al giudice amministrativo del Comitato.


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