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Banks Supplemental Application

Type
PDF
Last Updated
2016-07-19

Certificate of Compliance

You must submit this form to your employer's workers' compensation insurer or to your employer within 14 days of its receipt. Your workers' compensation benefits may be suspended if you do not timely submit this Certification. You would be entitled to all suspended benefits after this Certification is provided to your insurer, if you are otherwise eligible for benefits.

Type
PDF
Last Updated
2016-03-18

Certificate of Insurance Reference Guide

Type
PDF
Last Updated
2016-05-26

Choice of Physician

When you are injured at work or become sick because of something that happened at work, the law gives you the right to choose your own doctor in any field or specialty of medicine for medical treatment.

Type
PDF
Last Updated
2016-03-18

Choice of Physician

Employee’s Choice of Physician Form

Type
PDF
Last Updated
2016-03-18

Common Workers' Comp Terms

Type
PDF
Last Updated
2016-08-11

Designated Workplace Exclusion Request

Type
DOC
Last Updated
2016-05-26

Duties Should Injury Occur

Type
PDF
Last Updated
2016-06-14

Effective Safety Meetings - The Basics

Here are some basic points for you to consider when conducting a safety meeting.

Type
PDF
Last Updated
2016-03-17

EFT/ACH Payment Installment Form

Type
PDF
Last Updated
2016-10-27

Electrical Safety

Type
PDF
Last Updated
2016-07-19

Employee Request to Change Treating Doctor (English)

For use ONLY by Employees NOT in Workers’ Compensation Health Care Networks or Certain Political Subdivision Health Care Plans Type (or print in black ink) each item on this form

Type
PDF
Last Updated
2016-03-18

Employee Request to Change Treating Doctor (Spanish)

Para uso EXCLUSIVO de los Empleados que NO Participan en las Redes de Servicios Médicos de Compensación para Trabajadores o en Ciertos Planes de Salud de Subdivisiones Políticas Escriba a máquina (o a mano, usando tinta negra) cada artículo en este formulario

Type
PDF
Last Updated
2016-03-18

Employee’s Monthly Report of Earnings

Type
PDF
Last Updated
2016-03-18

ERM14

Type
PDF
Last Updated
2016-07-19

Excavation & Trenching Basics

Type
PDF
Last Updated
2016-07-19

First Fill Program Pharmacy Card

Type
DOC
Last Updated
2016-06-14

Showing 21 - 40 of 130 results