Application for Lump Sum/Advance Payment
Attorney Affiavit for Non-Liability Stipulations
Attorney Fee Approval
Attorney Leave of Absence
Attorney Withdrawal/Lein
Authorization and Consent to Release Information
Bill of Rights for the Injured Worker
Bill of Rights for the Injured Worker – (Spanish)
Case Progress Report
Change of Physician/Additional Treatment by Consent
Conformed Panel of Physicians
Conformed Panel of Physicians – (Spanish)
Credit/Reduction in Benefits
Employer’s First Report of Injury
Individuallized Rehabilitation Plan
Job Analysis
Medical Report
Motion/Objection to Motion
Notice of Claim/Request for Hearing/Request for Mediation
Notice of Payment or Suspension of Benefits
Notice of Payment or Suspension of Death Benefits
Notice of Election or Rejection of Workers’ Compensation
Notice of Intent to Become a Party at Interest
Notice of Representation
Notice of Use of Servicing Agent
Notice to Controvert
Notice to Employee of Rel to Return to Work with Restrictions
Notice to Employee of Offer of Suitable Employment
Panel of Physicians
Panel of Physicians – (Spanish)
Petition for Appointment of Temporary Guardianship of Minor
Petition for Appointment of Temp Guardian of Incapacitated
Rehabilitation Transmittal Form
Worker’s CompensationthSJC316012020-06-22T16:17:51-04:00