Notice to the Claimant, LIBC-758
The Department of Labor & Industry, Bureau of Workers' Compensation, has made the following revision to the LIBC-758:
After June 6, 2011, prior versions of this form will not be accepted by the bureau and will be returned to you.
- This form has been renamed “Notice to Employee”
An electronic version of the revised “Notice to Employee” and reproduction instructions are available online
Please note that this is a non-OCR form and does not need to be tested and approved by the bureau for formatting prior to use.