Louisiana Workforce Commission Forms

This form is used for selecting a physician in Louisiana workers' compensation cases.

This form is used for filing a disputed claim for medical treatment in the state of Louisiana. It allows individuals to contest a denial or disagreement with their medical treatment under the workers' compensation system.

This document is used for employees in Louisiana to certify their compliance with certain regulations or requirements.

This form is used for employees in Louisiana to report their earnings on a quarterly basis.

This form is used for filing a disputed claim for compensation in the state of Louisiana. It allows individuals to request a review of their denied workers' compensation claims.

This document is used for employers in Louisiana to apply for a La Unemployment Account.

This form is used for reporting fraud related to unemployment insurance benefits in the state of Louisiana.

This document is used to apply for the partial transfer of experience rating record in the state of Louisiana. It is necessary for businesses who wish to transfer a portion of their insurance experience rating from one company to another.

This Form is used for requesting an Independent Medical Exam in Louisiana.

This form is used for requesting a stop payment for workers' compensation benefits in Louisiana.

This form is used for amending the quarterly wage and tax report in the state of Louisiana.

This form is used for employees in Louisiana to report their monthly earnings.

This form is used for applying for approved training in Louisiana through the LWC-UI130 program.

This document certifies attendance at an event or program in Louisiana. It serves as proof of participation.

This document is a surety bond specific to the state of Louisiana. It is a legal agreement that ensures the performance or payment of an obligation.

This form is used for filing a motion in Louisiana to recognize the right to a social security offset.

This form is used for requesting a compromise or lump sum settlement in a workers' compensation case in Louisiana.

This form is used for the eligibility review process in Louisiana.

This document is used for protesting benefit charges in Louisiana.

This form is used for employees in Louisiana to notify their employer of their coverage as a multi-state worker.

This form is used for service companies in Louisiana to apply for workers' compensation coverage.

This form is used for making corrections to an employer's Social Security number in Louisiana.

This form is used for authorizing electronic funds transfer of LWC unemployment tax payments in Louisiana.

This form is used for requesting workers' compensation records in the state of Louisiana.

This document is used for evaluating settlements in the state of Louisiana. It helps to assess the potential costs and benefits of reaching a settlement agreement in legal cases.

This document is an application for the Directory of Safety Services in Louisiana. It is used to apply for inclusion in the directory as a safety service provider.

This type of document is a request form for language interpreter or deaf/hearing impaired assistance in the state of Louisiana.

This type of document is a legally binding agreement between a buyer and a seller, issued by a bank in Louisiana. It guarantees that payment will be made to the seller as long as all the terms and conditions of the credit are met.

This document is used for securing a certificate of deposit in the state of Louisiana. It outlines the terms and conditions of the agreement between the depositor and the financial institution.

This document is a legal agreement used in the state of Louisiana that establishes the terms and conditions of indemnification and guarantees between parties involved. It protects against potential financial losses or damages.

This form is used for requesting an order recognizing the right to social security offset in the state of Louisiana.

This form is used for reporting the first injury or illness that occurred in the workplace in the state of Louisiana.

This Form is used for submitting a Cost Containment Application in Louisiana, which helps employers control their workers' compensation costs.

This Form is used for employers in Louisiana to certify their compliance with workers' compensation requirements.

This document is used to request a waiver of payment of advance costs for employees in Louisiana.

This form is used for employers in Louisiana to apply for the privilege of paying workers' compensation benefits to their employees as a self-insurer.

This form is used for appealing for special reimbursement consideration in Louisiana.

This document is used to notify the Second Injury Fund in Louisiana about a claim.

This Form is used for reporting and paying unemployment insurance contributions for domestic services employees in Louisiana.

This document is a request for duplicate unemployment insurance documents in Louisiana. It is used to obtain copies of important paperwork related to unemployment benefits.