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Consider contacting your insurance company to make a First Report of Injury before you file a claim via CC-Form 3. (All Forms submitted to the Commission shall be in black print on white paper. Please do not use colored forms.)
Form 2 Employer's First Report of Injury. As soon as you have been notified of a work-related injury, please fill out this form and provide the original to the Workers' Compensation Court and a copy to EMPLOYERS.
Amount: compensation is equal to 70% of the difference between the employee's average weekly wages and the employee's wage-earning capacity in the same employment or otherwise, if less than before the injury. It may not exceed 80% of the employee's average weekly wages at the time of the accident.
When you are injured on the job and you are unable to work for more than 7 calendar days, you are eligible for weekly benefits amounting to 70% of your average weekly wage, up to the maximum set by law. The maximum is equal to the state's average weekly wage.
The Form 43 is to be completed by the respondent (employer/workers' compensation insurance carrier) to notify the Administrative Law Judge, the claimant (employee/decedent), and all parties to the claim of its intention to deny the compensability of all or part of the claimant's claim to workers' compensation benefits.
The form is listed under Affidavit of Exempt Status on the Case OK website. The cost for an Affidavit of Exempt Status is $50.00 plus a $1.00 online processing fee. Please note the Workers' Compensation Commission will not accept checks for the Affidavit of Exempt Status Fee.
Claims forms are on the Commission's website, .wcc.ok.gov. They also are available at both Commission locations, 1915 N. Stiles Avenue, Oklahoma City, OK 73105 and 210 Kerr State Office Building, 440 S. Houston, Tulsa, OK 74127.