Legal Forms >> North Dakota >> Workers' Compensation
Form #:ND-WC-SFN58278 North Dakota workers compensation form for a questionnaire to be completed by an employee whose injuries may have been made worse or aggravated by medical malpractice or negligence, with notice of the state's right to a lien against recovery from a third-party.
Name:Third Party Notice and Questionnaire - Medical Malpractice Form Number: ND-WC-SFN58278 State:North Dakota Statute: Form Category:Workers' Compensation
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