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 62 State Forms found

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WORKERS COMPENSATION – FIRST REPORT OF INJURY OR ILLNESS - INSTRUCTIONS

 Form IA-1 Instructions r 1-1-02

ACCIDENT PREVENTION SERVICES ANNUAL REPORT - INSTRUCTIONS

 Form HS-31-C Instructions Rev. 7-1-2010

Accident Prevention Services Worksheet - Instructions

 Form HS-31-D Instructions Rev. 7-1-2010

APPLICATION FOR CERTIFICATE OF NON-COVERAGE - INSTRUCTIONS

 Form AR-A - Instructions Revised 1-1-2024

CLAIM FOR COMPENSATION - INSTRUCTIONS

 Form AR-C Instructions Updated: 6-16-14

Contact Designation Form for CLAIM OFFICE - MEDICAL BILLING - UNDERWRITER - ADMINISTRATOR - INSTRUCTIONS

 Form O - Instructions Eff 7/01/2017

EMPLOYER’S INTENT TO ACCEPT OR CONTROVERT CLAIM - INSTRUCTIONS

 Form AR-2 - Instructions Revised 1-1-2013

Health Care Notice for Employees Under Managed Care - Instructions

 Form AR-H Instructions Revised 1-1-2001

CLAIMANT’S LUMP SUM REQUEST-RESPONDENT’S POSITION - INSTRUCTIONS

 Form AR-L Instructions Revised 1-1-2001

MONTHLY REPORT ON MEDICAL - ONLY INJURY DATA - INSTRUCTIONS

 Form AR-M Instructions Revised: 1-1-2001

NOTIFICACIÓN DE ACCIDENTE DEL EMPLEADO - INSTRUCTIONS

 Formulario AR-N Instructions Actualizada: 8-1-2006

RECLAMACIÓN DE COMPENSACIÓN - INSTRUCTIONS

 Formulario AR-C Instructions Actualizada 08-31-06

REPORT OF COMPENSATION PAID/SUSPENSION OF PAYMENTS - INSTRUCTIONS

 Form AR-4 Instructions Revised: 1-1-2011

VERIFICATION OF PERMANENT TOTAL DISABILITY - INSTRUCTIONS

 Form AR-V Instructions Revised 1-1-2001

WAGE STATEMENT IMMEDIATELY PRECEDING INJURY DATE - INSTRUCTIONS

 Form AR-W Instructions Revised: 1-1-2001
Disclaimer: These forms may not be the most recent version. Arkansas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
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