Oklahoma Workers Compensation Commission Forms

49
total templates

Documents

49

CC- Form 3 "Employee's First Notice of Claim for Compensation" - Oklahoma

Rate (4.5 / 5) 55 votes
Size: 1 MB
1 page

CC- Form 5 "Physician's Report of Release and Restrictions" - Oklahoma

Rate (4.3 / 5) 77 votes
Size: 465 KB
1 page

CC- Form 9 "Request for Hearing" - Oklahoma

Rate (4.4 / 5) 68 votes
Size: 413 KB
1 page

CC- Form A "Claimant's Application for Change of Physician and Request for Hearing" - Oklahoma

Rate (4.3 / 5) 53 votes
Size: 426 KB
1 page

CC- Form M "Request for Appointment of Independent Medical Examiner, Rehabilitation Evaluator, or Medical Case Manager" - Oklahoma

Rate (4.4 / 5) 37 votes
Size: 1 MB
1 page

CC- Form 2 "Employer First Notice of Injury" - Oklahoma

Rate (4.5 / 5) 68 votes
Size: 367 KB
1 page

CC- Form 7 "Designation of Service Agent" - Oklahoma

Rate (4.7 / 5) 61 votes
Size: 79 KB
1 page

CC- Form 3C "Claim for Workers' Compensation Discrimination or Retaliation" - Oklahoma

Rate (4.6 / 5) 75 votes
Size: 491 KB
1 page

CC- Form 3B "Employee's First Notice of Occupational Disease and Claim for Compensation" - Oklahoma

Rate (4.7 / 5) 60 votes
Size: 1 MB
1 page

CC- Form 3F "Employee's Notice of Claim for Benefits From the Multiple Injury Trust Fund" - Oklahoma

Rate (4.8 / 5) 86 votes
Size: 1 MB
1 page

CC- Form 13 "Request for Prehearing Conference" - Oklahoma

Rate (4.5 / 5) 72 votes
Size: 356 KB
1 page

CC- Form 3A "Claimant's First Notice of Death and Claim for Compensation" - Oklahoma

Rate (4.4 / 5) 72 votes
Size: 511 KB
1 page

CC- Form 10 "Answer and Notice of Contested Issues" - Oklahoma

Rate (4.6 / 5) 40 votes
Size: 416 KB
1 page

CC- Form 40 "Employer's Contest of Judgment of Noncompliance and Request for Hearing" - Oklahoma

Rate (4.4 / 5) 73 votes
Size: 1 MB
1 page

CC- Form 71 "Authorization for Attorney Representation" - Oklahoma

Rate (4.5 / 5) 55 votes
Size: 441 KB
1 page

CC- Form 50 "Medical Interlocutory Order Request" - Oklahoma

Rate (4.6 / 5) 69 votes
Size: 1 MB
1 page

CC- Form 93 "Application and Order for Leave to Withdraw as Attorney of Record" - Oklahoma

Rate (4.8 / 5) 100 votes
Size: 1 MB
1 page

CC- Form 99 "Pauper's Affidavit" - Oklahoma

Rate (4.5 / 5) 43 votes
Size: 428 KB
2 pages

MFDR Form 19 "Provider Request for Medical Fee Dispute Resolution" - Oklahoma

Rate (4.3 / 5) 30 votes
Size: 452 KB
1 page

CC- Form 17 "Physician Disclosure Statement" - Oklahoma

Rate (4.8 / 5) 30 votes
Size: 335 KB
1 page

CC- Form 100 "Claimant's Application and Order for Dismissal" - Oklahoma

Rate (4.6 / 5) 142 votes
Size: 1 MB
1 page

CC- Form 36A "Affidavit of Exempt Status Under the Administrative Workers' Compensation Act" - Oklahoma

Rate (4.7 / 5) 50 votes
Size: 159 KB
2 pages

CC- Form 36C "Cancellation of Affidavit of Exempt Status Under the Administrative Workers' Compensation Act" - Oklahoma

Rate (4.8 / 5) 37 votes
Size: 1 MB
1 page

CC- Form 10C "Employer's Response to Claim for Workers' Compensation Discrimination or Retalation" - Oklahoma

Rate (4.3 / 5) 48 votes
Size: 1 MB
1 page

CC- Form 300 "Request for Proceeding Regarding Arbitration Agreement" - Oklahoma

Rate (4.3 / 5) 104 votes
Size: 354 KB
1 page

MFDR Form 10M "Response to Provider Request for Medical Fee Dispute Resolution" - Oklahoma

Rate (4.6 / 5) 10 votes
Size: 469 KB
1 page

CC- Form 211 "Request for Review of Adverse Benefit Determination" - Oklahoma

Rate (4.3 / 5) 81 votes
Size: 427 KB
1 page

CC- Form 626 "Medical Case Manager Application" - Oklahoma

Rate (4.5 / 5) 68 votes
Size: 413 KB
1 page

CC- Form 463 "Application for Independent Medical Examiner" - Oklahoma

Rate (4.4 / 5) 72 votes
Size: 366 KB
1 page

CC- Form 926 "Application for Appointment as Certified Workers' Compensation Mediator" - Oklahoma

Rate (4.3 / 5) 20 votes
Size: 505 KB
1 page

CC- Form 862 "Vocational Rehabilitation Services (Vrs) Registry Form" - Oklahoma

Rate (4.5 / 5) 33 votes
Size: 355 KB
1 page

Form SI-LOC "Letter of Credit - Sample Form" - Oklahoma

Rate (4.3 / 5) 24 votes
Size: 55 KB
1 page

CC- Form A ORDER "Order for Change of Treating Physician" - Oklahoma

Rate (4.3 / 5) 14 votes
Size: 283 KB
1 page

Sample Form SI-BOND "Surety Bond of Self-insurer of Workers' Compensation" - Oklahoma

Rate (4.6 / 5) 7 votes
Size: 80 KB
5 pages

Form SI GROUP "Application for Group Self Insurance Association Permit" - Oklahoma

Rate (4.4 / 5) 28 votes
Size: 251 KB
3 pages

Form JP-APPENDIX "Joint Petition Settlement Appendix" - Oklahoma

Rate (4.7 / 5) 86 votes
Size: 91 KB
1 page

Form SI EMPLOYER "Application for Individual Own Risk Employer Permit" - Oklahoma

Rate (4.6 / 5) 7 votes
Size: 502 KB
5 pages

Form CC-JOINT PETITION "Joint Petition Settlement" - Oklahoma

Rate (4.6 / 5) 37 votes
Size: 259 KB
1 page

"Request for Claims File Information" - Oklahoma

Rate (4.3 / 5) 16 votes
Size: 110 KB
2 pages