Erin Westvang 10/12/2023 - Laserfiche WebLink

Page l3 Claim Status The order paid, claim as is part open of the and will be closed with benefits by Department as already agreement Closing Order The order paid. claim as is part open of and the agreement will be closed with benefits by Department as already Condition(s) Accepted Conditions There are no Department -ordered accepted conditions. Denied Conditions By the diagnosed [sic], aggravated disease issued order and an for dated as AC affirming by which subacromial arthrosis 09/02/2016, is the the not industrial order claim responsible because bursitis, on the was 09/27/2016. Department they injury filed for rotator were or The the not cuff occupational determined Department conditions caused teninitis or Employer CLAIM 2. = , Claim Number SG-86079 Date of Industrial Injury 10/04/2012 Description of Accident The Claimant sustained a left eye abrasion at work. Nature Condition and and Extent Disability of She preinjuiy received status treatment with no and permanent her condition impairment. returned to Date Claim Received The claim was received on or about 10/04/2012. Date of Claim Allowance is can of the no be order Department presumed allowance to order be order allowed closing in at the the least file, claim as but of dated the the There claim date 10/30/2013. Date Allowance Final Order At after least the on Claimant or about receipt 12/10/2013, of approximately the closing order. 60 days Became Claim Status agreement. The 10/30/2013, claim was and closed will remain by Department closed as order part dated of this Closing Order The 10/30/2013, agreement. claim was and closed will remain by Department closed as order part of dated this Accepted Conditions There conditions treated are under but no the the Department claim. condition orders of left accepting eye abrasion any was Denied Conditions are no in this orders claim. denying or segregating any There conditions