Workers Compensation Forms and Templates

This Form is used for submitting an amended true-up payroll report for Ohio. It is used to correct any errors or omissions in the original report.

This form is used for certifying workers' compensation in the state of Florida. It ensures that employers have the necessary insurance coverage to provide benefits to injured workers.

This form is used for objecting to a payment bill for treatment provided in New York.

This form is used for addressing overpayment recovery questions related to the Office of Workers' Compensation Programs (OWCP).

This document is used for reporting a status change in workers' compensation claims in the state of Oregon.

This document is for employees in Tennessee to choose their physician for medical panels.

This form is used for verifying worker's compensation insurance in California. It helps ensure that employees are covered by the necessary insurance in case of a workplace injury.

This form is used for providing detailed information about the time spent by an employee on work-related activities. It helps track the hours worked, breaks, and any additional time off, such as holidays or leave.

This form is used for providing worker's compensation insurance information in the state of Maryland.

This document is a checklist that outlines the requirements for workers' compensation in North Carolina. It provides information on the necessary steps and documentation needed to comply with the state's workers' compensation laws.

This form is used for requesting preferred worker status in the state of Washington for individuals who speak Oromo.

This form is used to notify individuals in New York of their right to choose a healthcare provider authorized by the Workers' Compensation Board. It is available in both English and French.

This document is used to inform workers in New York of their right to choose a healthcare provider authorized by the Workers' Compensation Board. It is available in both English and Urdu.

This form is used for making a claim for compensation in a death case in New York. It is available in French language.

This Form is used for injured workers in New York who need to request assistance. The form is available in French.

This Form is used for self-insurers in New York to report their payroll for all operations.

This Form is used for requesting preferred worker status in Washington state. The form is available in Korean language.

This Form is used for employers in New York to report the wages earned by an employee before their injury or illness.

This Form is used for providing Workers' Compensation filing information in the state of Washington. It is required for employers to report their employees' compensation coverage details.

This document is used for requesting a Workers' Compensation Certificate in Oneida County, New York. It is necessary to obtain this certificate for certain legal or business requirements related to worker's compensation.

This Form is used for the Salary Continuation Agreement in the State of Ohio.