GA State Board of Workers' Compensation
Showing 1–16 of 36 results
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Annual Water Use Report Form for a Significant Water Withdrawal Facility
INDNR21915R $189.00 -
Application for Lump Sum/Advance Payment
GAWC25 $89.00 -
Attorney Affidavit for No-Liability Stipulations
GAWC15 $69.00 -
Attorney Fee Approval
GAWC108A $69.00 -
Attorney Leave of Absence
GAWC102J $69.00 -
Attorney Withdrawal/Lien
GAWC108B $69.00 -
Authorization and Consent to Release Information
GAWC207 $69.00 -
Case Progress Report
GAWC4 $89.00 -
Change of Physician/Additional Treatment by Consent
GAWC200A $69.00 -
Credit Reduction of Benefits
GAWC243 $69.00 -
Employer’s First Report of Injury
GAWC1 $129.00 -
Fraud and Compliance Request for Hearing or Trial Division Intervention
GAWC24 $89.00 -
Individualized Rehabilitation Plan
GAWCR2A $129.00 -
Job Analysis
GAWC240A $69.00 -
Medical Report
GAWC20A $89.00 -
Motion/Objection to Motion
GAWC102G $69.00