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State Workers' Compensation Forms

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  1. California First Report of Injury Form

    California First Report of Injury Form

    $14.95

    California employers are required by law to complete a report of injury form upon receiving notification that an employee has been injured at work. The complete and dated form must then be given to an employee and insurer or claims administrator within one working day of the receipt of the form.

    The California First Report of Injury Form is exactly what you need to provide an initial employee injury report. In a single 8.5 x 11 page, all of the key information you need to capture is easily and clearly organized for you. This ensures that your form is complete, and that you are following mandatory regulations – and protecting the success and stability of your business.

    Plus, each package of California First Report of Injury Forms contains 25 forms, so you don't have to worry about running out.

    Product Specifications:

    • Each form is 8.5" x 11"
    • 25 Forms/Pkg
    Learn More
  2. California Time of Hire Workers' Compensation Pamphlet

    California Time of Hire Workers' Compensation Pamphlet

    $15.95

    California Time of Hire Workers' Compensation Pamphlet Update

    Effective July 1, 2014, the CA workers' compensation regulations will include new rules when pre-designating a physician or medical group for work-related injuries and illnesses. Part of this revision is the addition of two forms. The pamphlet is updated with the new regulations as well as the addition of the two new forms.

    About the California Time of Hire Workers' Compensation Pamphlet

    California law requires all employers to provide each new employee, either at the time of hire or by the end of their first pay period, the 'Written Notice to New Employees' concerning their rights, benefits and obligations under the CA workers' compensation law. The California Time of Hire Workers' Compensation Pamphlet is approved by the Division of Workers' Compensation to satisfy the employer's notification requirement.

    Each order includes 25 pamphlets with 25 forms for pre-designating a physician and 25 forms for pre-designating a chiropractor, acupuncturist or medical group.

    Product Specifications:

    • One packet includes 25 pamphlets, plus 25 each of the 2 forms
    • Each four-fold pamphlet is 2.8" x 8.5"
    • Each form is 8.5" x 11"
    • Available in English or Spanish
    Learn More
  3. Front

    Colorado First Report of Injury Form

    $14.95

    The Colorado Department of Labor and Employment requires that you promptly report any instance of employee injury. Your failure to do this can lead to serious regulatory and legal consequences down the road.

    You can safely avoid these consequences and help promote a safe, smart workplace with our Colorado First Report of Injury Forms. Each form is a single 8.5 x 11 page, and covers all of the information that the CDLE needs to promptly receive. And since each package comes with 25 forms, you won't have to worry about running out – when supplies get low, simply order more.

    Product Specifications:

    • 25 forms / package, 8.5 x 11
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  4. Front

    Delaware First Report of Injury Form

    $14.95

    In Delaware, you're legally obligated to promptly report any instance of employee injury to the Delaware Office of Workers' Compensation. Doing so ensures that your business is compliant with the law, and that you're protecting yourself from any regulatory or legal penalties due to overlooking this critical task.

    Save time, effort and costs by using the Delaware First Report of Injury form. Each 8.5 x 11 form covers all of the information that the Delaware Office of Workers' Compensation expects to promptly receive after any and all workplace injury.

    Plus, each package of Delaware First Report of Injury forms contains 25 forms, so you don't have to worry about running out.

    Product Specifications:

    • 25 forms / package, 8.5 x 11
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  5. Florida First Report of Injury Form

    Florida First Report of Injury Form

    $14.95

    Injuries and illnesses occur at the workplace at any moment.  Ensuring an employee's safety at the workplace is every employer's duty.  Inform your employee of their rights as an injured worker.

    Product Specifications:

    • This form is 8.5" x 11"
    • One packet includes 25 forms
    Learn More
  6. Florida Workers Compensation Notification Letter

    Florida Workers Compensation Notification Letter

    $14.95

    Dealing with employees that are injured on the job requires a high level of professionalism and attention to detail. The employer and all representatives are required to act swiftly and provide the injured employee with details regarding rights and the process. Workers Compensation lawsuits can be very expensive and use excessive resources. Each questionable incident should be handled correctly from the beginning to avoid complications.

    The Florida "Injured Employee" letter will enable the employer to quickly contact the injured party. By using these letters the employer can be confident that the situation is being handled responsibly and within the law. Although the letter is initiated by the employer, the letter is from the Florida Division of Worker's Compensation and it carries the state seal. This gives the letter authority and lets the injured party know that the incident will be handled correctly. Employers that have a high concentration of native Spanish speaking employees should send the letter in both English and Spanish.

    Product Specifications:

    • This form is 8.5" x 11"
    • 25 forms / package
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  7. Florida Workers Compensation Pamphlet

    Florida Workers Compensation Pamphlet

    $11.99

    Product Specifications:

    • This 3 fold pamphlet is 3.6" x 8.5"
    • One packet includes 25 pamphlets
    Learn More
  8. Front

    Idaho First Report of Injury Form

    $14.95

    The growth and success of your business doesn't just depend on your revenues and profits; it also depends on your ability to maintain a safe workplace. And part of that legal obligation involves immediately reporting any workplace injury to the State of Idaho Industrial Commission. Your failure to do so can result in severe regulatory and legal penalties.

    The Idaho First Report of Injury forms are exactly what you need to fulfil your obligations. Each 8.5 x 11 form contains all of the first report information you need to cover. Simply fill it out, submit it promptly to the Commission, and keep your workplace safe, law-abiding and successful.

    Plus, each package of Idaho First Report of Injury forms contains 25 forms, so you don't have to worry about running out.

    Product Specifications:

    • 25 forms / package, 8.5 x 11
    Learn More
  9. Front

    Indiana First Report of Injury Form

    $14.95

    Product Specifications:

    • This form is 8.5" x 11"
    • 25 forms / package
    Learn More
  10. Front

    Kansas First Report of Injury Form

    $14.95

    Product Specifications:

    • This form is 8.5" x 11"
    • 25 Forms/Package
    Learn More

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