Workers' Compensation Commission

Showing 1–16 of 29 results

Default sorting Sort by popularity Sort by latest Sort by price: low to high Sort by price: high to low

• 

  AL WC: Supplementary Report

  ALWC3 $89.00
• 

  Answer

  MSWCB5-22 $69.00
• 

  Application for Approval of Non-Schedule Adjustment

  NYWC_C-22 $89.00
• 

  Application for Lump Sum Payment

  MSWCB19 $69.00
• 

  Certificate of Insurance

  91d521786005 $129.00
• 

  Certificate of Insurance

  GENCOI $89.00
• 

  Claim Summary Form

  ALWC4 $89.00
• 

  Designation of Authorized Representative

  NYWCDB840 $89.00
• 

  Employer’s First Report of Injury

  ILIC45 $89.00
• 

  Employer’s First Report of Injury or Occupational Disease

  ALWC2 $89.00
• 

  Employer’s Notice of Controversion

  MSWCB52 $69.00
• 

  Employer’s Supplementary or Final Report of Injury or Illness

  ILIC85 $89.00
• 

  First Report of Injury or Illness

  IA-1-AR $89.00
• 

  Illinois Initial IC Reporting Forms (IC-45, IC-85)

  ILIC45P85 $129.00
• 

  Medical Records Affidavit

  MSWCMRA $69.00
• 

  Medical Records Affidavit

  MSMRA $69.00