16 | Agreement for Permanent Disability/ Disfigurement Compensation | PDF | Doc | $50.00 if Claimant Represented |
16A | Agreement for Permanent Disability/ Disfigurement Compensation (injuries after July 1, 2007) | PDF | Doc | $50.00 if Claimant Represented |
17 | Receipt of Compensation | PDF | Doc | No Fee |
20 | Statement of Earning of Injured Employee | PDF | Doc | No Fee |
24 | Application for Lump Sum Award | PDF | Doc | $50.00 |
27 | Subpoena | PDF | Doc | No Fee |
30 | Request for Commission Review (Appellate Panel Review) | PDF | Doc | $150 |
32 | Request to Waive Filing Fee | PDF | Doc | No Fee |
50 | Employee's Notice of Claim or Hearing Request | PDF | Doc | $50/ Hearing Request only |
52 | Employee's Notice of Claim or Hearing Request (Death Claim) | PDF | Doc | $50.00/ Hearing Request only |
58 | Pre-Hearing Brief | PDF | Doc | No Fee |
59 | Appellant's Informational Brief | PDF | Doc | No Fee |
65 | Occupational Disease Waiver | PDF | Doc | No Fee |
S-2 | Notice of Third-Party Action (Employee) | PDF | Doc | No Fee |
| Single Commissioner Decision & Order Template | | Doc | No Fee |
| Appellate Panel Decision & Order Template | | Doc | No Fee |
| Certificate of Service | | Doc | No Fee |