Workers Compensation Forms and Templates

This document is used for filing a workers' compensation appeals docketing statement in the state of West Virginia. It provides information about the case and initiates the appeals process.

This document is used for reporting a workplace injury in the state of Georgia, United States.

This document is for those who want to become a workers' compensation self-insurance fund in the state of Louisiana. It is an application form that needs to be filled out and submitted to the relevant authorities.

This form is used for employers and employees in Ohio to select a state other than Ohio as the exclusive remedy for workers' compensation claims.

This Form is used for notifying individuals about the denial of their compensation claim in Tennessee. It is available in both English and Spanish.

This Form is used for filing a claim for compensation and giving notice of a third party action in the state of New York. It is available in Haitian Creole language.

This form is used for employers in Texas to contest the compensability of a worker's compensation claim.

This form is used for employers in Texas to notify the workers' compensation insurance agency when they have no coverage or are terminating their coverage.

This form is used for resolving benefit disputes in Texas. It helps parties involved in a dispute come to an agreement related to employee benefits.

This form is used for individuals in Texas who wish to elect to engage in arbitration for a legal dispute instead of going to court.

This Form is used for employers in Texas to apply for reimbursement under the Return-To-Work program.

This form is used for Texas employees to request a change of their treating doctor.

This form is used as a legal document and filled out by a treating physician of an employee with a work-related injury or illness to request authorization of special medical treatment, services, and procedures.

This form is used for contacting the workers' compensation carrier in Utah.

This document is used for submitting a claim for benefits related to pneumoconiosis (lung diseases caused by inhalation of certain dust particles) in the state of Virginia.

This form is used for waiving occupational disease coverage in Virginia.

This Form is used for reporting a patient's medical information by their attending physician in the state of Virginia.

This type of document, the VWC Form 35 Fatal Award Agreement, is used in Virginia for the settlement of worker's compensation claims involving fatal injuries.

This form is used for referral in Virginia when there is a lack of coverage.