Addendum To Application For Adjudication Of Claim To Identify Legal Entity {WCAB-2}

WCAB Form 2, ADDENDUM TO APPLICATION FOR ADJUDICATION OF CLAIM TO IDENTIFY LEGAL ENTITY EMPLOYING INJURED WORKER. This Addendum is to be used where the Application for Adjudication of Claim does not set forth the full or complete legal name of the entity (defendant) allegedly employing the injured worker. Use this Addendum to more fully identify the legal entity named on the "Employer Name" line at the top of page two of the Application for Adjudication of Claim (DWC/WCAB Form 1A). A separate Addendum is to be completed for each distinct legal entity or defendant named in the Application for Adjudication of Claim. This Addendum is to be served with the Application for Adjudication of Claim and Special Notice of Lawsuit on each named defendant. A copy of this Addendum must be filed at the Workers' Compensation Appeals Board together with the Application for Adjudication of Claim, Special Notice of Lawsuit, and a Proof of Service. The Proof of Service must specifically state that the Addendum was served together with the Application for Adjudication of Claim and Special Notice of Lawsuit. PLEASE NOTE: This Addendum does not substitute for an amended application for adjudication of claim to name a different employer. www.FormsWorkflow.com