Board Rule 61(b)(22). Form WC-104. Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations
For non-catastrophic accidents occurring on or after July 1, 1992, the employer/insurer shall send this form to the employee no later than 60 days after the medical release of the employee to return to work with restrictions or limitations.
- Form WC-104/Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations
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