WCC PDF Forms

Form Name	Form Number
Complaint About a Workers' Compensation Administrative Law Judge (01-2008)	Complaint Form
Declaration of Readiness to Expedited Hearing - Form with Instructions - SPANISH (05-2007)	I&A6(sp)
Declaration of Readiness to Proceed - Form with Instructions - SPANISH (05-2007)	I&A5(sp)
Declaration of Readiness to Proceed - with Instructions (05-2007)	I&A 5
Declaration of Readiness to Proceed to Expedited Hearing (Trial) - with Instructions (05-2007)	I&A 6
Denial of Vocational Rehabilitation Benefits (RU-500Y)	RU-500Y
Description Of Employees Job Duties	RU 91
DWC SB 899 Notice	DWC SB 899 Notice
EDEX client acknowledgment of legal constraints on access to information and use of information (06-2006)
EDEX client list (06-2006)
EDEX subscriber application (06-2006)
Employee's Claim For Workers' Compensation Benefits (07-2004)	DWC-1
Employee's Permanent Disability Questionnaire	DEU100
Employee's Request For Informal Permanent Disability Rating	DEU 200
Employer's Report Of Occupational Injury Or Illness	DLSR 5020
Fee Disclosure Statement	DWC 3
Finding and Order (Replacement QME Represented)
Finding and Order (Replacement QME Unrepresented)
Finding and Order RE: Second QME Panel (Unrepresented Case)
Finding and Order RE:Second QME Panel (represented case)
For More Information	Fact Sheet #4
Frequently Asked Questions Regarding the Self Insurer's Annual Report
Glossary of workers' compensation terms for injured workers (07-2005)	Fact Sheet B
Glossary of workers' compensation terms for injured workers - Spanish (09-2005)	Fact Sheet B
How to correctly name your employer for the Uninsured Employers Fund (05-2007)	IA16A
How to correctly name your employer for the Uninsured Employers Fund - Spanish (07-2007)	IA 16A
How to File a Claim with the Uninsured Employers Fund - Form and Instruction Packet - SPANISH (05-2007)	I&A16(sp)
How to File a Claim with the Uninsured Employers Fund - Forms and Instructions (05-2007)	I&A 16
How to file a complaint with the Audit Unit (06-2006)	DWC-AU-905
Hurt on the Job? for Young Workers	Fact Sheet Young Workers