This is a sample form only. Claimant should fill out the form on their insurer or administrator's website and submit the form directly to them.Discover how to create a comprehensive compensation agreement with this template and get answers to FAQs to ensure you cover everything crucial. LawDepot's Compensation Agreement template is customizable to make it easy for you to document your employee's new compensation. Each document on 360 Legal Forms is customized for your state. Clarify how new employees or contractors will get paid using this free compensation agreement template. A Voluntary Agreement memorializes the details of a workers' compensation injury. The agreement must be clearly filled out and uploaded following the guidelines in the EDI Implementation Guide.