Special Resources » Forms: Insurance
Download a large number of workers compensation forms. Sample bid package - forms, checklists, etc. used by a university's risk management department. Series of risk management forms and letters. Forms for life & health, property casualty, WC insurance, etc.
The following is the collection of special resources throughout the library. Click on main category / sub-category for that section of the library OR Click on resource title for immediate access to the resource.
Driver Safety » Driver Policies
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.
Health Benefits » Employer Health Benefits
Health and pharmaceutical plan benefit resources for employers
Health and pharmaceutical plan benefit resources for employers
TPA Employee Health Care Benefits Audit Program [27552] 
Third Party Administrator Internal Audit Procedures checklist
Third Party Administrator Internal Audit Procedures checklist
Employment Practices Risk Management Audit [9621]
Self audit related to hiring practices, terminations, etc.
Self audit related to hiring practices, terminations, etc.
Occupational Health » Return to Work
Managing workers compensation costs by returning injured workers to work
Managing workers compensation costs by returning injured workers to work
14 Day Injury Report Form ![[pdf]](graphics/file_pdf.gif)
[34242]
Example of a form to be completed when an injured employee has been off the job for 14 days due to the injury
[34242] Example of a form to be completed when an injured employee has been off the job for 14 days due to the injury
Chapter 5 Return to Work Program [9428]
Full text of WC return to work program for state agencies in Texas - plus, checklist & forms
Full text of WC return to work program for state agencies in Texas - plus, checklist & forms
GA-Georgia Return to Work Manual & Forms [19674]
Manual & forms used in the state of Georgia's RTW program for state employees
Manual & forms used in the state of Georgia's RTW program for state employees
Implementing a Job Task Bank [25367]
Steps for creating a list of duties that can be offered to an injured worker who is returning to work
[25367] Steps for creating a list of duties that can be offered to an injured worker who is returning to work
Modified Duty Employee Acknowledgement Form [26466]
A sample form that is signed by the injured worker to accepts a modified work assignment (pdf)
[26466] A sample form that is signed by the injured worker to accepts a modified work assignment (pdf)
Temporary Modified Duty for Industrial Injuries [16322]
Text of a policy that outlines the procedures plus a sample letter to be sent to the injured worker
Text of a policy that outlines the procedures plus a sample letter to be sent to the injured worker
Uniform Workability Report Form [23461]
Provides essential management information concerning the health status of an injured worker after each physician visit
Provides essential management information concerning the health status of an injured worker after each physician visit
Staffing » Volunteer Management
Articles, sample policies and agreements related to volunteer management
Articles, sample policies and agreements related to volunteer management
Volunteer Injury Coverages [15781]
Full text of a risk management policy in use by state agencies in Oregon - includes forms
Full text of a risk management policy in use by state agencies in Oregon - includes forms
Self Insurance: Alaska Employer Guidance for WC Self Insurance [11151]
Series of documents, forms, etc. related to self-insurance in the State of Alaska
Series of documents, forms, etc. related to self-insurance in the State of Alaska
Self Insured Employers WC Forms [23181]
Download WC forms for self-insured employers in the State of Arizona
Download WC forms for self-insured employers in the State of Arizona
Self Insurance: Connecticut: Employer Self-Insurance Application Package [11201]
Information package for employers wishing to self-insure their WC liabilities - includes forms
[11201] Information package for employers wishing to self-insure their WC liabilities - includes forms
Self-Insurer WC Application - Louisiana [23188]
Download the application to become self-insured for WC in LA
Download the application to become self-insured for WC in LA
Missouri WC Self-Insurance Program [15295]
Information and forms for the Missouri self-insurance program for WC
Information and forms for the Missouri self-insurance program for WC
US State Government » NH-New Hampshire
Access to state agencies and laws for the state of New Hampshire
Access to state agencies and laws for the state of New Hampshire
Self Insurance: New Hampshire Self Insurance Statutes and Application [11233]
Provides links to the WC self-insurance laws and can download the self-insurance application
Provides links to the WC self-insurance laws and can download the self-insurance application
Self Insurance Information - New York WC [5012]
Information for self insuring for workers compensation in the State of New York
Information for self insuring for workers compensation in the State of New York
Plain Language Summary of Law Changes [20929]
A brief summary of legislative changes to the Worker’s Compensation Act
A brief summary of legislative changes to the Worker’s Compensation Act
US State Government » WV-West Virginia
Access to state agencies and laws for the state of West Virginia
Access to state agencies and laws for the state of West Virginia
Self Insurance: West Virginia Self-Insurance Program [11270]
Download forms, checklists and general information about self-insurance in West Virginia
Download forms, checklists and general information about self-insurance in West Virginia
Workers Compensation » WC Administration
Support materials for implementation of workers compensation programs
Support materials for implementation of workers compensation programs
NV-Nevada Risk Management Program [15585]
Forms, program materials, checklists for state agencies in Nevada
Forms, program materials, checklists for state agencies in Nevada
State Workers Compensation Program [14523]
Full text of the WC program and forms in use by a state government for their employees
Full text of the WC program and forms in use by a state government for their employees
Forms - Division of Longshore and Harbor Workers' Compensation [11747]
Download approximately 20 forms
Download approximately 20 forms
Workers Compensation » WC Forms
Download state workers compensation forms such as first report of injury
Download state workers compensation forms such as first report of injury
AK-Alaska - Workers Compensation Forms [6243]
Download Alaska workers compensation forms, first report of injury and more
Download Alaska workers compensation forms, first report of injury and more
AR-Arkansas - Workers Compensation Forms [1568]
Nearly 20 different workers compensation forms for the state of Arkansas may be downloaded
Nearly 20 different workers compensation forms for the state of Arkansas may be downloaded
AZ-Arizona - Workers Compensation Forms [10615]
Workers comp forms, self-insured forms, ADOSH forms and more
Workers comp forms, self-insured forms, ADOSH forms and more
CA-California - Self-insured WC Forms [4957]
Download workers compensation forms for the state of California self-insureds
Download workers compensation forms for the state of California self-insureds
CA-California - WC Forms in Numerical Order [4950]
Download physician and employer first report of injury forms, etc for the state of California
Download physician and employer first report of injury forms, etc for the state of California
CA-California - Workers Compensation Forms [10303]
Download a set of WC forms for the state of California
Download a set of WC forms for the state of California
CO-Colorado Questionable WC Claim Notice [34241]
Example of an attachment to First Notice of Loss when employer doubts injury has occurred
[34241] Example of an attachment to First Notice of Loss when employer doubts injury has occurred
CT-Connecticut - Workers Compensation Forms [3541]
Large number of forms from the Connecticut Workers Compensation Commission
Large number of forms from the Connecticut Workers Compensation Commission
FL-Florida - Workers Compensation Forms [4959]
Download over 50 commonly used workers compensation forms for Florida
Download over 50 commonly used workers compensation forms for Florida
GA-Georgia - Workers Compensation Forms [6267]
Download a large number of workers compensation forms for the state of Georgia
Download a large number of workers compensation forms for the state of Georgia
GA-Georgia Subsequent Injury Trust Fund Claim Form [20036]
Download the claim form - also provides statutory filing requirements
Download the claim form - also provides statutory filing requirements
ID-Idaho - Workers Compensation Forms Used by the Industrial Commission [6251]
Download WC forms for the state of Idaho
Download WC forms for the state of Idaho
KS-Kansas - Workers Compensation Forms [3903]
Download a large number of WC forms for the state of Kansas
Download a large number of WC forms for the state of Kansas
KS-Kansas Self Insurance Forms [11205]
Download Kansas WC self-insurance application forms - spreadsheets
Download Kansas WC self-insurance application forms - spreadsheets
KY-Kentucky - Workers Compensation Forms [4966]
Download forms used for workers compensation in Kentucky
Download forms used for workers compensation in Kentucky
LA-Louisiana - Workers Compensation Forms & Instructions [7972]
Download WC forms for the state of Louisiana
Download WC forms for the state of Louisiana
MA-Massachusetts - Workers Compensation Forms [6259]
Download WC forms for the state of Massachusetts
Download WC forms for the state of Massachusetts
MI-Michigan - Workers Compensation Forms [5788]
Download WC forms, including the Employers Basic Report of Injury
Download WC forms, including the Employers Basic Report of Injury
MO-Missouri - Workers Compensation Forms [10080]
Download frequently used workers compensation forms
Download frequently used workers compensation forms
MT-Montana - Workers Compensation Court Forms [10092]
Download legal forms for the Workers Compensation Court of Montana
Download legal forms for the Workers Compensation Court of Montana
NC-North Carolina - Workers Compensation Forms [4986]
Download forms required for workers compensation in North Carolina
Download forms required for workers compensation in North Carolina
NE-Nebraska: Workers Compensation Forms [3020]
Download forms related to workers compensation in Nebraska
Download forms related to workers compensation in Nebraska
NJ-New Jersey - Workers Compensation Forms & Brochures [6286]
Download workers compensation forms for the state of New Jersey
Download workers compensation forms for the state of New Jersey
NM-New Mexico - Workers Compensation Forms [6288]
Download workers compensation forms for the state of New Mexico
Download workers compensation forms for the state of New Mexico
NY-New York - Workers Compensation Forms [4979]
Download commonly used forms required for WC in the state of New York
Download commonly used forms required for WC in the state of New York
NY-New York Independent Medical Examination (IME) Forms [15221]
Download IME forms for the state of New York
Download IME forms for the state of New York
OR-Oregon - Workers Compensation Forms [4984]
Download a very large number of workers compensation forms for Oregon
Download a very large number of workers compensation forms for Oregon
RI-Rhode Island - Workers Compensation Forms [16124]
Download WC forms for the State of Rhode Island
Download WC forms for the State of Rhode Island
SC-South Carolina Workers Compensation Forms [23170]
Download a series of workers compensation forms for the state of South Carolina
Download a series of workers compensation forms for the state of South Carolina
SD-South Dakota - Workers Compensation Forms [13521]
Download WC forms including First Report of Injury for South Dakota
Download WC forms including First Report of Injury for South Dakota
TN-Tennessee WC Forms [14401]
Download a series of workers compensation forms for the state of Tennessee
Download a series of workers compensation forms for the state of Tennessee
US Division of Coal Mine Workers' Compensation Forms - Black Lung [29025]
OWCP forms for federal workers to apply for workers compensation benefits under Black Lung benefits
OWCP forms for federal workers to apply for workers compensation benefits under Black Lung benefits
US Division of Energy Employees Occupational Illness Compensation Claims Forms [29026]
Claims forms for benefits under the Energy Employees Occupational Illness Compensation Program Act
Claims forms for benefits under the Energy Employees Occupational Illness Compensation Program Act
US Division of Federal Employees’ Compensation Forms [29023]
OWCP forms for federal workers to apply for workers compensation benefits
OWCP forms for federal workers to apply for workers compensation benefits
US Division of Longshore and Harbor Workers' Compensation Forms [29024]
OWCP forms for federal workers to apply for workers compensation benefits under Longshore benefits
OWCP forms for federal workers to apply for workers compensation benefits under Longshore benefits
VA-Virginia - Workers Compensation Commission Forms [13084]
Download WC forms for the state of Virginia - self-insurance forms, etc
Download WC forms for the state of Virginia - self-insurance forms, etc
WI-Wisconsin - Workers Compensation Forms [4803]
Access a variety of forms (e.g., first report of injury) related to workers compensation
Access a variety of forms (e.g., first report of injury) related to workers compensation
WV-West Virginia - Workers Compensation Forms [4782]
Download more than 50 different West Viriginia state WC forms - all in pdf format
Download more than 50 different West Viriginia state WC forms - all in pdf format
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