All Kentucky Workers Compensation forms

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Discovery

• Claimant's First Set of Interrogatories to Employer and Carrier US-01365
• Claimant's First Set of Requests for Production US-01366
• Requests for Production of Documents to Carrier US-01367

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Official - Claims

• Application for Resolution of Injury Claim KY-101-WC

Workers Compensation - Official - Coverage

• Application for Split Coverage KY-375-WC
• Application for Split Coverage Wrap Up KY-375W-WC

Workers Compensation - Official - Disputes

• Medical Dispute KY-112-WC

Workers Compensation - Official - Medical

• Medical Report Injury KY-107I-WC
• Medical Report Occupational Disease KY-108CWP-WC
• Medical Report Occupational Disease KY-108O-WC

Workers Compensation - Official - Payments

• Request for Payment KY-HBL-114-WC

Workers Compensation - Official - Wages

• Wage Certification KY-AWW1-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Reports

• Medical Report Hearing Loss KY-108H-WC
• Medical Report Psychological KY-107P-WC