Report serious injuries immediately by telephone to your insurer's claims department, then file this form with your insurance company or self-insurer claims office.

If you are injured or become ill, either physically or mentally, because of your job, including injuries resulting from a workplace crime, you may be entitled to workers’ compensation …

The WC1 Form should be filled out by the Clerk of the Court when submitting unclaimed restitution to the Virginia Victims Fund. This form should also be submitted by the Clerk of …

Every work injury to an employee causing absence for one day or more or which requires medical services other than first aid treatment must be reported within 7 working days after the injury. …

Provide Feedback on Our Website and Resources. If you would like a copy of any of the forms as a Word document, please email the Education & Outreach team at …

Instructions: The information below is needed to accurately credit this account for any period of Workers' Compensation. Please attach copies of supporting documents such as Notice of …

WC-1 Section I All Information Must Be Completed by Injured Employee. The receipt of a claim number does not entitle an employee to benefits under WV Workers’ Compensation Law. In …

To receive this clearance certificate, individual taxpayers must meet the following requirements: All Indiana tax returns must be filed and up to date. All outstanding tax delinquencies must be …

To download a free pdf viewer, visit Adobe. WC-36; This form can only be completed by Workers’ Compensation carriers. Contact your carrier for information. For employees: TDI-45 Claim for …

Employers with one or more employees, whether working full-time or part-time, are directly affected. The information provided here is intended to assist employers, employees and …