Injury or disease details sheet
How can I access this form?
na
Form file format
Form ID
D2049
Audience
General
This is not a claim form. It must be used as an attachment to either the D2020 Claim for Rehabilitation and Compensation or D2051 Claim for Liability and/or Reassessment of Compensation.
If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.