LHCSIF Claim Forms

Employee Accident Report Form (LWC - WC IA - 1)

Supervisor Report Form

Refusal of Medical Treatment

Do & Don’t Claims

Employer Certificate of Compliance

Medical Authorization Form

Witness Report Form

Investigation - Resident Handling

On the Job Injury Checklist

Medical Questionnaire

Investigation - Slip, Trip & Fall

Part Time Form

Workers' Compensation (LWC)