Kentucky Department of Workers' Claims Forms

This document is used for legally compelling someone to provide testimony or evidence in a court case in the state of Kentucky.

This document is used to request the production of specific documents or evidence for a court case in Kentucky.

This document is used for attorney fee elections in the state of Kentucky.

This form is used for notifying the designated physician in the state of Kentucky. It is a mandatory requirement for certain legal proceedings or insurance claims.

This form is used for requesting payment for services or reimbursement for compensable expenses in the state of Kentucky.

This document is a Social Security Release Form used in the state of Kentucky. It allows individuals to authorize the release of their Social Security information for specific purposes.

This form is used for self-insurers in Kentucky to enter into a guarantee agreement.

This form is used for employers in Kentucky who want to apply for permission to carry their own risk without insurance.

This Form is used for applying for a continuous bond in the state of Kentucky. It is required for businesses that engage in certain activities like importing or exporting goods. The bond acts as a guarantee for compliance with relevant laws and regulations.

This form is used for adding a surety rider to a contract or agreement in the state of Kentucky. It provides additional security for a party involved in the contract.

This form is used for requesting a letter of credit in the state of Kentucky.

This Form is used for an injured individual and their employer in Kentucky to agree on compensation for the injury.

This form is used for notifying claimants in Kentucky about the denial or acceptance of their claim.

This form is used for certifying the average weekly wage of an injured worker in Kentucky after the injury has occurred. It helps determine the amount of compensation they may receive.

This document is used for applying for interlocutory relief in the state of Kentucky to resolve a claim.

This form is used to certify the average weekly wage in the state of Kentucky. It is used to determine the amount of compensation for injured workers.

This form is used for certifying the average weekly wage for concurrent employment in Kentucky.

This form is used for resolving medical disputes in the state of Kentucky.

This document is used for outlining the proposed agreements and notifying of any contested issues in a legal case in Kentucky.

This form is used to request a substitution of a party and ensure that benefits continue in the state of Kentucky.

This form is used for filing a claim for injury in the state of Kentucky. It allows individuals to seek resolution and compensation for their injuries.

This Form is used for documenting the employment history of a plaintiff in a court case in the state of Kentucky.

This form is used for reporting occupational diseases in Kentucky. It is a medical report that helps in documenting and investigating work-related illnesses.

This form is used to file a motion to reopen a case in the state of Kentucky. It is typically filed when new evidence or legal arguments are discovered after a final decision has been made.

This form is used for reporting alleged safety violations made by an employee in Kentucky.

This Form is used for alleging safety violations by an employer in Kentucky.

This Form is used for requesting an expedited medical determination in Kentucky. It is for individuals who need urgent medical coverage.

This form is used for reaching an agreement on compensation and obtaining approval for a settlement related to a fatality in the state of Kentucky.

This document is for setting up electronic trading partnerships with businesses in the state of Kentucky. It contains information and requirements for creating profiles for electronic transactions.

This form is used for submitting a medical report in the state of Kentucky. It is specifically for workers' compensation cases.

This Form is used for reporting medical information related to injuries, hearing loss, and psychological conditions in the state of Kentucky.

This form is used for documenting the plaintiff's chronological medical history in Kentucky. It helps in organizing and presenting the plaintiff's medical information in a timeline format.

This Form is used for workers in Kentucky who have developed hearing loss, occupational disease, or coal workers' pneumoconiosis (CWP) seeking compensation and approval for settlement agreements.

This form is used for registering an employee leasing company in the state of Kentucky.

This form is used for providing information about the lessee in the state of Kentucky.

This Form is used for requesting a manual change in Kentucky.

This form is used for employees in Kentucky to file a motion to reopen their case.

This Form is used for filing a motion to reopen a workers' compensation claim for benefits under Kentucky law (KRS 342.732).