IR Economic Loss information. Required information is bold. (only if EconLoss is yes)- IR EconLoss Claim
- Is economic loss being claimed? (yes/no)
- IR EconLoss WageAmount
- Amount of Last Annual Wages
- IR EconLoss WagesDate
- IR EconLoss Full-Time
- IR EconLoss Part-Time
- IR EconLoss Retired
- IR EconLoss PartiallyDisabled
- IR EconLoss TotallyDisabled
- IR EconLoss Deceased
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