Workers Compensation Forms and Templates

This form is used for conducting a pre-audit questionnaire in Ohio.

This document is used for creating a rehabilitation agreement in Ohio. It is a form that outlines the terms and conditions for the rehabilitation process.

This form is used for applying for accrued compensation in the state of Ohio.

This Form is used for individuals who are claiming exempt status under the Administrative Workers' Compensation Act in Oklahoma.

This form is used for requesting a rebate from the Oklahoma Workers' Compensation Multiple Injury Trust Fund.

This Form is used for obtaining a surety bond to cover certified self-insurance liabilities in the state of Texas.

This form is used for parental guaranty in the state of Texas. The form is used to secure payment for medical treatment given to a minor child by a healthcare provider.

This form is used for obtaining a parental guaranty for a subsidiary in Texas that is not fully owned.

This form is used for granting power of attorney in the state of Texas. It allows an individual (the principal) to appoint someone else (the agent) to make decisions and take legal actions on their behalf.

This form is used for obtaining a surety bond to cover assumed certified self-insurance liabilities in the state of Texas.

This form is used for reporting seasonal wages in Rhode Island. It is used by employers to provide a statement of wages paid to seasonal workers.

This document is used by employers in Texas to report any work-related injuries or illnesses suffered by their employees.

This type of document is a notice to employees in Texas about workers' compensation. It provides information about the benefits and rights related to workers' compensation in the state.

This document provides information to employees in Texas regarding workers' compensation. It explains their rights and benefits in case of a work-related injury or illness.

This form is used for making corrections, revisions or endorsements to an existing insurance policy in the state of Texas.

This Form is used for making a claim for workers' compensation death benefits in the state of Texas.

This form is used for electing to engage in arbitration in the state of Texas.

This form is used for describing the injured employee's employment in Texas. It provides details about the employee's job duties, working conditions, and employment history.

This document is used for issuing a final order regarding permanent total disability in the state of Tennessee.

This form is used for notifying waiver of workers' compensation benefits for specific medical conditions in Tennessee.

This Form is used for employers in Vermont to report the first injury or illness that occurs on the job.

This Form is used for employees in Vermont to report an injury at work and file a claim for compensation.

This Form is used for agreeing on permanent partial or permanent total disability compensation in Vermont.

This document provides a report on the alternative dispute resolution process for workers' compensation in Vermont. It outlines the methods used to resolve disputes between employers and employees regarding work-related injuries.

This Form is used for reporting workers' compensation information in the state of Texas.

This form is used for rescinding a notice of claim of common law rights in the state of Rhode Island.

This form is used in Rhode Island for exempt corporate officers to elect to become subject to workers' compensation.

This form is used for applying for approval of a workers' compensation self-insurance program in Rhode Island.

This document is a notice used to inform an individual in Texas of an adverse determination regarding their workers' compensation claim for non-network providers.

This Form is used for submitting delegation data for the HMO/Workers' Compensation Health Care Network (Wcn) in Texas.

This form is used for the agreement of assumption and guarantee of workers' compensation liabilities by a certified self-insurer in Washington state.

This form is used for self-insured employers in Washington to certify their excess insurance coverage.

This form is used for applying to become a designated doctor in Texas.