Forms

 Submit forms via our Secure Workers’ Compensation Submission Form (an OnBase/PolyDoc form), sealed inter-office mail (marked as Confidential), or in person within 24 hours of the supervisor’s knowledge. Do not email or fax any documents that contain Social Security numbers or any other personally identifiable information.

• Medical Service Order (MSO) (pdf)
• Manager's Report (pdf)
• Workers' Compensation Claim Form (pdf)
• Transitional Work Plan (doc)
• Physician Pre-Designation Forms

    More information on How to Submit Forms Securely