Occupational Disease Templates

This Form is used for filing an occupational disease claim in the state of Utah. It is the official form required for workers who have contracted a disease as a result of their job.

This form is used for reporting work injuries or occupational diseases in Utah.

This form is used for employers in Alabama to report an employee's injury or occupational disease to the State Employees' Insurance Board.

This form is used for filing a petition for settlement in Montana when there is an injury or occupational disease with reserved medical benefits.

This form is used for reporting work-related injuries or occupational diseases in Nevada. It is known as the Notice of Injury or Occupational Disease (Incident Report) form C-1.

This document is used for reporting occupational diseases and injuries in the state of Maryland.

This Form is used for employees in Oklahoma to report their first notice of occupational disease and file a claim for compensation.

This form is used for employees and physicians in West Virginia to report occupational injuries or diseases.

This form is used for agreeing on compensation and approving settlements for occupational disease or hearing loss cases in Kentucky.

This form is used for applying to resolve a claim related to occupational disease in the state of Kentucky.

This form is used for employees in Texas to file a claim for compensation if they have a work-related injury or occupational disease.

This form is used for reporting known or suspected occupational diseases in Michigan. It is required for employers to document and report any diseases that may be related to the workplace.

This form is used for reporting occupational diseases and employment history in Washington specifically for individuals who speak Chuukese.

This form is used for recording occupational diseases and employment history in Washington. It is specific to the Kunama region.