DIY Forms | Workers Compensation
Workers Compensation
If you file a case with the Clerk of Court, you must include the Filing Information and Final Disposition forms.
Application for Lump Sum/Advance Payment
Attorney Affidavit for No-Liability Stipulations
Authorization and Consent to Release Information
Bill of Rights for the Injured Worker
Bill of Rights for the Injured Worker - Spanish
Change of Physician/Additional Treatment by Consent
Conformed Panel Of Physicians
Conformed Panel Of Physicians - Spanish
Consolidated Yearly Report of Medical Only Cases
Credit/Reduction in Benefits
Employer's First Report of Injury
Individualized Rehabilitation Plan
Notice of Claim/Request for Hearing/Request for Mediation
Notice of Payment or Suspension of Benefits
Notice of Payment or Suspension of Death Benefits
Notice of Election or Rejection of Workers' Compensation
Notice of Intent to Become a Party at Interest
Notice of Use of Servicing Agent
Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations
Notice to Employee of Offer of Suitable Employment
Panel of Physicians -Spanish
Petition for Appointment of Temporary Guardianship of Minor
Petition for Appointment of Temporary Guardianship of Legally Incapacitated
Rehabilitation Transmittal Form
Request for Authorization of Treatment or Testing by Authorized Medical Provider
Request for Catastrophic Designation
Request for Copy of Board Records
Request for Settlement Mediation
Request for Rehabilitation Closure
Request/Objection for Change of Physician/Additional Treatment
Standard Coverage Form Group Self-Insurance Fund Members
WC/MCO Panel
