Workers' Compensation Forms

The following links will assist you with filing Worker's Compensation forms.

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

Workers Compensation Employee Forms

Links

• Employee Workers' Comp Statutory Timelines
• Pharmacies

Forms

• C-1 - Fillable Notice of Injury Form
• C-1 - Notice of Injury Form 
• Description Of Employee Rights (D-2 Form)
• Employee Responsibility Form/Info
• Leave Choice Form
• Physical Assessment Form
• Application for Reimbursement of Claim Related Travel Expenses Form (D-26)