All New Hampshire Workers Compensation forms

Workers Compensation - Analysis

• Workers' Compensation Task Analysis NH-01-WC

Workers Compensation - Claims

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

Workers Compensation - Disability

• Department of Labor - Disability Reward NH-10A-WC
• Record of Extended Disability NH-74A-WC

Workers Compensation - Discovery

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

Workers Compensation - Employers

• Employers Supplemental Report of Injury NH-13A-WC
• Employers First Report of Occupational Injury or Disease NH-8-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 - Lump Sums

• Lump Sum Settlement Agreement NH-15A-WC

Workers Compensation - Medical

• Workers' Compensation Medical Form NH-75A-WC

Workers Compensation - Official - General

• Notice of Accidental Injury or Occupational Disease NH-8A-WC
• Memo of Payment of Disability Compensation NH-9A-WC
• Memo of Denial of Workers' Compensation Benefits NH-9A-1-WC

Workers Compensation - Official - Settlements

• Release and Settlement of Claim NH-3PR-1-WC

Workers Compensation - Official - Wages

• Wage Schedule NH-76A-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Wages

• Supplemental Wage Schedule NH-76A-1-WC