Library For Workers
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Brochures:
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Decision Review Office Brochure
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 (pdf 676kb)
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Employee's Guide to Workers Compensation Claims
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(pdf 193kb)
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Injured Workers Guide to Voc Rehab
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(pdf 80kb)
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Preferred Worker Program - Brochure
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(pdf 90kb)
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Workers' Compensation and You: A Guide for Injured Workers
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(pdf 314kb)
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Forms:
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Adult Learning Center Attendance Log - C67
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(pdf 31kb)
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Chemical Exposure Questionnaire - C151
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(pdf 21kb)
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Customer Service Feedback Form
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(pdf 29kb)
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Dermatitis Questionnaire - C150
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(pdf 26kb)
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(pdf 25kb)
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(pdf 40kb)
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First Report of Injury Instructions
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(pdf 254kb)
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Foot and Ankle Questionnaire – C131
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(pdf 26kb)
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Hearing and Noise Questionnaire - C129
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(pdf 29kb)
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Hernia Questionnaire - C149
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(pdf 21kb)
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Independent Exercise Program Log (C59)
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(pdf 42kb)
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Injured Worker Status Report - FL214
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(pdf 83kb)
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Preferred Worker Program - Worker Registration
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(pdf 16kb)
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Prior Injury Questionnaire
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(pdf 54kb)
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Release of Information for WSI Authorization - C57b
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(pdf 10kb)
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Repetitive Motion Questionnaire - C63
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(pdf 37kb)
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Request for Personal Reimbursement - C40a
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(pdf 42kb)
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Request for Personal Reimbursement for Home Health Care - C40b
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(pdf 45kb)
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Transitional Job Offer Form (C165)
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(pdf 29kb)
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Manuals:
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(pdf 2350kb)
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