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Workers' Compensation Supervisor Forms

Procedures

  • Procedure Flowchart
  • Supervisor Checklist
  • Supervisor Workers' Comp Statutory Timelines
  • Early Return to Work Policy
  • Workers' Comp S.A.M. 0524

Forms

  • C-3 Fillable Form - Employer's Report of Industrial Injury or Occupational Disease
  • C-3 Form - Employer's Report of Industrial Injury or Occupational Disease
  • D-8 - Employer's Wage Verification Form
  • Offer of Modified Duty Form
  • Supervisor's Accident Investigation Form
  • Physical Characteristics Form

Forms to Provide and Review with Injured Employees

  • C-1 - Fillable Notice of Injury Form
  • C-1 - Notice of Injury Form
  • Employee Responsibility Form
  • Leave Choice Option Form
  • Physical Assessment Form

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