All Virginia Workers Compensation forms

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG
• Claimant's Affidavit for Workers' Compensation VA-002-WC

Workers Compensation - Discovery

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

Workers Compensation - Employers

• Employers Accident Report for Workers' Compensation VA-003-WC
• Employers Application for Hearing for Workers' Compensation VA-005A-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 - Mediation

• Request for Mediation for Workers' Compensation VA-007-WC

Workers Compensation - Official - Charts

• Amputation Chart - Hand for Workers' Compensation VA-001-WC
• Amputation Chart - Foot for Workers' Compensation VA-001A-WC

Workers Compensation - Official - Physicians

• Attending Physicians Report for Workers' Compensation VA-006-WC

Workers Compensation - Official - Subpoenas

• Subpoena for Witness for Workers' Compensation VA-009-WC
• Subpoena Duces Tecum for Workers' Compensation VA-008-WC
• Witness Subpoena for Workers' Compensation VA-0011-WC

Workers Compensation - Official - Wages

• Termination of Wage Loss Award for Workers' Compensation VA-0046-WC
• Wage Chart for Workers' Compensation VA-0010-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038