Tennessee Department of Labor and Workforce Development Forms

This form is used as an addendum to the Petition for Benefit Determination for Death Claims Only in the state of Tennessee.

This document is an addendum to the application for determining death benefits in Tennessee. It is used specifically for claims related to death.

This form is used for requesting mediation in Tennessee for injuries that occurred before July 1, 2014.

This form is used for requesting settlement approval in the state of Tennessee.

This form is used for filing a petition for benefit determination in Tennessee. It is available in both English and Spanish.

This document is a Spanish version of the C-42 (LB-0382) form used in Tennessee. It is an agreement between employer and employee regarding the choice of physician.

This form is used for applying for an operating permit for amusement devices in the state of Tennessee.

This form is used for applying to the Drug Free Workplace Program in Tennessee. It is available in both English and Spanish.

This form is used for requesting an investigation in the state of Tennessee.

This Form is used for requesting an investigation in Tennessee, both in English and Spanish.

This Form is used for the selection of participants in the Trade Adjustment Assistance Program in Tennessee.

This Form is used for notifying individuals about the denial of their compensation claim in Tennessee. It is available in both English and Spanish.

This form is used for applying to transfer your experience rating record in Tennessee.