Form DA WC4000 Transitional Duty Employment Audit Form - Louisiana

Form DA WC4000 Transitional Duty Employment Audit Form - Louisiana

What Is Form DA WC4000?

This is a legal form that was released by the Louisiana Division of Administration - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form DA WC4000?A: The Form DA WC4000 is the Transitional Duty Employment Audit Form for Louisiana.

Q: What is the purpose of the Form DA WC4000?A: The purpose of the Form DA WC4000 is to conduct an audit of transitional duty employment in Louisiana.

Q: Who uses the Form DA WC4000?A: Employers, insurance carriers, and third-party administrators in Louisiana use the Form DA WC4000.

Q: What information is required on the Form DA WC4000?A: The Form DA WC4000 requires information about the injured employee, the transitional duty job, and the dates and duration of the transitional duty employment.

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Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Louisiana Division of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DA WC4000 by clicking the link below or browse more documents and templates provided by the Louisiana Division of Administration.

Download Form DA WC4000 Transitional Duty Employment Audit Form - Louisiana

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