| Board Rule 61(b)(1) |
Form WC-1. Employer's First Report of Injury |
| Board Rule 61(b)(2) |
Form WC-2. Notice of Payment or Suspension of Benefits |
| Board Rule 61(b)(3) |
Form WC-2A. Notice of Payment or Suspension of Death Benefits |
| Board Rule 61(b)(4) |
Form WC-3. Notice to Controvert |
| Board Rule 61(b)(5) |
Form WC-4. Case Progress Report |
| Board Rule 61(b)(6) |
Form WC-6. Wage Statement |
| Board Rule 61(b)(7) |
Form WC-10. Notice to Elect or Reject Coverage |
| Board Rule 61(b)(8) |
Form WC-11. Standard Coverage Form |
| Board Rule 61(b)(9) |
Form WC-12. Request for Copy of Board Records |
| Board Rule 61(b)(10) |
Form WC-14. Notice of Claim/Request for Hearing or Mediation |
| Board Rule 61(b)(11) |
Form WC-14A. Request to Change Information on a Previously Filed Form WC-14 |
| Board Rule 61(b)(12) |
Form WC-15. Attorney Certification for No-Liability Stipulated Settlements |
| Board Rule 61(b)(13) |
Form WC-20(a). Medical Report |
| Board Rule 61(b)(14) |
Form WC-24. Enforcement Division Request for Board Intervention |
| Board Rule 61(b)(15) |
Form WC-25. Application for Lump Sum/Advance Payment |
| Board Rule 61(b)(16) |
Form WC-26. Consolidated Yearly Report of Medical Only Claims and Annual Payments on Indemnity Claims |
| Board Rule 61(b)(17) |
Form WC-100. Request for Settlement Mediation |
| Board Rule 61(b)(18) |
Form WC-102. Request for Documents from Parties |
| Board Rule 61(b)(19) |
Form WC-102B. Notice of Representation by an attorney for an employer, insurer, or party-at-interest |
| Board Rule 61(b)(20) |
Form WC-102C. Attorney Leave of Absence |
| Board Rule 61(b)(21) |
Form WC-102D. Motion/Objection to Motion |
| Board Rule 61(b)(22) |
Form WC-104. Notice to Employee of Medical Release to Return to Work with Restrictions or Limitations |
| Board Rule 61(b)(23) |
Form WC-108a. Attorney Fee Approval |
| Board Rule 61(b)(24) |
Form WC-108b. Attorney Withdrawal/Attorney Fee Lien |
| Board Rule 61(b)(25) |
Form WC-121. Change of TPA Claims Office/Servicing Agent |
| Board Rule 61(b)(26) |
Form WC-131. Permit to Write Insurance |
| Board Rule 61(b)(27) |
Form WC-131(a). Permit to Write Insurance Update |
| Board Rule 61(b)(28) |
Form WC-200a. Change of Physician/Additional Treatment by Consent |
| Board Rule 61(b)(29) |
Form WC-200b. Request/Objection for Change of Physician/Additional Treatment |
| Board Rule 61(b)(30) |
Form WC-205. Request for Authorization of Treatment or Testing by Authorized Medical Provider |
| Board Rule 61(b)(31) |
Form WC-206. Reimbursement Request of Group Health Insurance Carrier/Healthcare Provider |
| Board Rule 61(b)(32) |
Form WC-207. Authorization and Consent to Release Information |
| Board Rule 61(b)(33) |
Form WC-208a. Application for certification of WC/MCO |
| Board Rule 61(b)(34) |
Form WC-226(a). Petition for Appointment of Temporary Guardianship of Minor |
| Board Rule 61(b)(35) |
Form WC-226(b). Petition for Appointment of Temporary Guardianship of Legally Incapacitated Adult |
| Board Rule 61(b)(36) |
Form WC-240. Notice to Employee of Offer of Suitable Employment |
| Board Rule 61(b)(37) |
Form WC-240A. Job Analysis |
| Board Rule 61(b)(38) |
Form WC-243. Credit |
| Board Rule 61(b)(39) |
Form WC-244. Reimbursement Request of Group Insurance Carrier/Disability Benefits Provider |
| Board Rule 61(b)(40) |
Form WC-262. Payment of Temporary Partial Disability Income Benefits |
| Board Rule 61(b)(41) |
Form WC-Change of Address. Change of Address |
| Board Rule 61(b)(42) |
Form WC-R1. Request for Rehabilitation |
| Board Rule 61(b)(43) |
Form WC-R1CATEE. Employee Request for Catastrophic Designation |
| Board Rule 61(b)(44) |
Form WC-R2. Rehabilitation Transmittal Report |
| Board Rule 61(b)(45) |
Form WC-R2A. Individualized Rehabilitation Plan |
| Board Rule 61(b)(46) |
Form WC-R3. Request for Rehabilitation Closure |
| Board Rule 61(b)(47) |
Form WC-R5. Request for Rehabilitation Conference |
| Board Rule 61(b)(48) |
Form WC-Rehabilitation Registration Application |
| Board Rule 61(b)(49) |
Form WC-Rehabilitation Registration Application Renewal |
| Board Rule 61(b)(50) |
Form WC-Catastrophic Rehab Release |
| Board Rule 61(b)(51) |
Form WC-P1 (Color of paper: Pink). Panel of Physicians |
| Board Rule 61(b)(52) |
Form WC-P2 (Color of paper: Pink). Conformed Panel of Physicians |
| Board Rule 61(b)(53) |
Form WC-P3 (Color of paper: Pink). WC CO Panel |
| Board_Rule_61(b)(54) |
Form WC-Bill of Rights (Color of paper; Pink). Bill of Rights |
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