Alaska Workers Compensation - Statewide forms

Workers Compensation - Statewide - Applications

• Application for Certificate of Self-Insurance AK-6129-WC

Workers Compensation - Statewide - Claims

• Workers Compensation Claim AK-6106-WC

Workers Compensation - Statewide - Medical

• Workers Compensation Medical Summary AK-6103-WC

Workers Compensation - Statewide - Notices

• Controversion Notice AK-07-6105-WC
• Notice of Possible Claim Against the Second Injury Fund AK-07-6110-WC
• Notice of Possible Claim Against the Second Injury Fund AK-6110-WC
• Employers Notice of Insurance AK-6120-WC

Workers Compensation - Statewide - Petitions

• Petition to Join Second Injury Fund and Claim for Reimbursement AK-6109-WC
• Petition for Workers Compensation AK-6111-WC

Workers Compensation - Statewide - Physicians

• Physician Report AK-6102-WC

Workers Compensation - Statewide - Releases

• Release of Counseling, Psychological, Psychiatric, or Alcohol / Drug / Substance Abuse Treatment Records or Information AK-002-WC

Workers Compensation - Statewide - Renewals

• Renewal of Certificate for Self-Insurance AK-6130-WC

Workers Compensation - Statewide - Reports

• Waiver of Reemployment Benefits AK-011-WC
• Compensation Report AK-07-6104B-WC
• Report of Occupational Injury or Illness AK-07-6101-WC

Workers Compensation - Statewide - Requests

• Request for Conference AK-6135-WC

Workers Compensation - Statewide - Subpoenas

• Subpoena for Workers Compensation AK-6112-WC