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 52 State Forms found

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Employee's Notice of Claim and/or Request for Hearing - EDI

 WCC Form # 50 Revised 9/2023

FIRST REPORT OF INJURY OR ILLNESS - EDI ONLY

 WCC FORM 12A REV. DATE 04/06

Physician's Statement - EDI

 WCC Form #14B 12/2016

Agreement for Permanent Disability / Disfigurement Compensation - EDI

 WCC Form # 16 Rev. 9/07

Agreement for Permanent Disability / Disfigurement Compensation - Injuries occurring after July 1, 2000 - EDI

 WCC Form # 16A 10/2017

ANNUAL MINOR MEDICAL REPORT - EDI

 WCC Form # 12M Rev. 5/06

APPELLANT’S INFORMAL BRIEF - EDI

 WCC Form # 59 Rev. 10/2017

Application for Lump Sum Award - EDI

 WCC Form # 24 Rev. 9/90

APPLICATION FOR MEMBERSHIP IN A SELF-INSURED FUND - EDI

 WCC Form # 6A Revised 8/22

APPLICATION TO CREATE A SELF-INSURANCE FUND

 WCC Form # 6 Rev. 04/00

APPLICATION FOR EMPLOYER TO INDIVIDUALLY SELF-INSURE

 WCC Form # 7 Revised 9/24

ATTORNEY FEE PETITION

 WCC Form # 61 Revised 7/08

CORPORATE GUARANTY

 WCC Form # 7A Revised 9/24

CORPORATE OFFICER NOTICE TO REJECT

 WCC Form # 5 Rev. 05/2013

Court Certificate

 WCC Form # S-4 Rev. 1986
Disclaimer: These forms may not be the most recent version. South Carolina 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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