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Connecticut Physician's Permanent Impairment Evaluation Form 42
SKU: FFCT185 |   E-mail this product to a friend
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Product Description

The Form 42 “PHYSICIAN’S PERMANENT IMPAIRMENT EVALUATION” is to be completed by the examining licensed physician to report a claimant’s permanent partial loss or loss of use of a body part, as well as the likely date of the claimant’s maximum medical improvement.
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