Worker Forms & Fact Sheets
We want you to be as up-to-date and informed as possible. View fact sheets and other publications that contain valuable information and answers to your questions.
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There are three options when completing forms:
1. Download, print and complete by hand before mailing/faxing, or
2. Download, complete on screen, print and sign before mailing/faxing.
3. Some forms can be completed online.
|Form Name||Last modified|
|Authorization Letter of Representation (WREP)||2015-Dec-18|
|Authorization to Release Information and Documentation (WMROI)||2015-Dec-18|
|Consent to Release of Personal Claims Information to Third Party||2016-Aug-23|
|Direct Deposit Application||2016-Jul-08|
|Hearing Loss Questionnaire||2015-Dec-18|
|Job Information Worksheet||2015-Nov-01|
|School Attendance Declaration (DSAQ)||2015-Dec-18|
|Statutory Declaration – spouse (D34F)||2016-Jan-29|
|File Update Customer Information (WC) online||N/A|
|Verification of Income Statement (REQ)||2014-Oct-30|
|Verification of Spousal Income Statement (SREQ)||2014-Oct-30|
|File Worker Appeal Form online||N/A|
|Worker’s Election Form (WEF)||2015-Dec-18|
|Worker’s Expense Statement (W6)||2016-Nov-1|
|Worker’s Initial Report of Injury (W1)
OR: Report Online
|Worker’s Medical Expense Statement (WME)||2016-Feb-29|
|Worker’s Progress Report (W3)||2016-Jul-14|
|Worker’s Request for Copy of File (WROI)||2015-Dec-18|
Fact Sheets & Publications
Please contact us if you experience any difficulties printing or downloading any of the publications above.