| Title |
Last Updated |
| Fraud Complaint |
March 30, 2016 |
| Settlement Agreement - Section 32 WCL |
March 30, 2016 |
| Attending Psychologists Report |
March 30, 2016 |
| Ancillary Medical Report |
March 30, 2016 |
| Doctors Initial Report |
March 30, 2016 |
| Cover Sheet-Rebuttal Of Application For Board Review |
December 15, 2015 |
| Cover Sheet-Application For Board Review |
December 15, 2015 |
| Report Of Work-Related Injury Or Occupational Disease |
August 3, 2015 |
| Renewal Application For License To Appear On Behalf Of Or Represent Carriers And-Or Self-Insurers |
July 28, 2015 |
| Initial Application For License To Appear On Behalf Of Or Represent Carriers And-Or Self-Insurers |
July 28, 2015 |
| Initial Application By Employee Of Licensee Under Section 50 3-b Or 50 3-d To Appear Before WCB |
May 4, 2015 |
| Stockholder Of Corporation Applying For License To Represent Self-Insurers |
May 4, 2015 |
| Notice Of Treatment Issue(s)-Disputed Bill Issue(s) |
April 13, 2015 |
| Statement Of Registration (Section 13n-WCL) |
April 13, 2015 |
| Employers First Report Of Work-Related Injury Or Illness |
April 13, 2015 |
| Impartial Specialists Report Of Medical Records Review |
April 13, 2015 |
| Practitioners Report Of Functional Capacity Evaluation |
April 13, 2015 |
| Proof Of Death By Physician Last In Attendance On Deceased |
April 13, 2015 |
| Claim For Compensation In Death Case |
April 13, 2015 |
| Carriers Or Self Insured Employers Objection To Attending Doctors Request For Medical Authorization Determination |
April 13, 2015 |
| Attending Doctors Request For Medical Authorization Determination |
April 13, 2015 |
| Application For Reopening Of Claim More Than Seven Years After Accident |
April 13, 2015 |
| Claimants Record Of Medical And Travel Expenses |
April 13, 2015 |
| Application For Approval Of Non-Schedule Adjustment |
April 13, 2015 |
| Attending Doctors Request For Authorization And Carriers Response |
December 23, 2014 |
| Cover Sheet-Rebuttal Of Application For Full Board Review |
October 7, 2014 |
| Independent Examiners Report Of Request For Information Or Response To Request Regarding Ind Med Exam |
August 5, 2014 |
| Carriers Request For Reimbursement Of Compensation Payments Under Section 14(6) (Blue Paper) |
July 21, 2014 |
| Political Subdivisions Report Of Injury To Volunteer Firefighter |
September 19, 2013 |
| Notice To Chair Of Carriers Action On Claim For Benefits |
September 19, 2013 |
| Notice That Right To Compensation Is Controverted |
September 19, 2013 |
| Modification Of Previous Report (ADR Program) |
September 18, 2013 |
| Employers Statement Of Wage Earnings Preceeding The Date Of Accident |
September 18, 2013 |
| Employers Report Of Work-Related Injury-Illness |
September 18, 2013 |
| Cover Sheet-Application For Full Board Review |
September 18, 2013 |
| Application For Advance On Periodic Payments Of Compensation |
September 18, 2013 |
| Political Subdivisions Report Of Injury To Volunteer Ambulance Worker |
September 13, 2013 |
| Notice Of Retainer And Appearance Or Notice Of Substitution And Appearance |
September 12, 2013 |
| Practitioners Report of Independent Medical Examination |
September 12, 2013 |
| Notice That Payment Of Compensation Has Been Stopped Or Modified |
September 11, 2013 |
| Employers Report Of Injured Employees Change In Employment Status Resulting From Injury |
June 18, 2013 |
| Attorney-Representatives Certification Of Form C-3 Or Notice Of Controversy |
June 14, 2013 |
| Renewal Application For License To Appear On Behalf Of Claimant |
September 5, 2012 |
| Record Of Percentage Hearing Loss |
July 11, 2012 |
| Notice To Health Care Provider And Injured Worker Of Carriers Refusal To Pay All (Or Portion Of) Medical Bill |
February 14, 2011 |
| Discharge Or Discrimination Complaint |
February 14, 2011 |
| Notice Of Right To Reimbursement Of Compensation Payments |
February 14, 2011 |
| Reclamacion Del Empleado |
February 1, 2011 |
| Practitioners Report Of Request For Information Or Response To Request Regarding Independent Medical Examination |
February 1, 2011 |
| Agreed Upon Findings And Awards For Proposed Conciliation Decision (Represented Claimants Only) |
January 14, 2011 |
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