Summary of Key Elements
{"Image DocumentName": "Summary of Key Elements", "Image ImageDescription": "The status of the case by marking the appropriate box on each DFS-F2-DWC-1 filed with the Division; Box 1(a) Denied Case Box 1(b) Indemnity Only Denied Case Box 2 Medical Only which became Lost Time Case Box 3 Lost Time Case", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}