Virginia Workers' Compensation Commission Forms
Documents:
56
This form is used for reporting the annual payroll of a city, town, or county that operates as a self-insurer in Virginia. It provides information on the wages paid to employees and helps in determining insurance premiums.
PDF 
Word
This form is used for employers in Virginia to apply for individual self-insurance under the Virginia Workers' Compensation Act.
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 document is used to request an expedited hearing in Virginia.
This type of document is a letter addressed to the beneficiary in a fatal case in Virginia. It is used for informing the beneficiary of their entitlement to receive a certain benefit or compensation following the death of an individual.
This form is used for referral in Virginia when there is a lack of coverage.
