All Nebraska 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 - Doctors

• Employees Choice or Change of Doctor Form - Spanish NE-050-SP-WC

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 - Medical Examiners

• Independent Medical Examiner Application for Appointment NE-062-WC
• Request for Independent Medical Examiner NE-063-1-WC

Workers Compensation - Notices

• Notice of Agreement to Use a Named Independent Medical Examiner NE-067-2-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038