Tools & Documents for Workers

Authorization for Release of Protected Health Information

Authorization for release of protected health information (HIPAA compliant)

Type: PDF
Last Updated: 2023-07-26

Certificate of Compliance

You must submit this form to your employer's workers' compensation insurer or to your employer within 14 days of its receipt. Your workers' compensation benefits may be suspended if you do not timely submit this Certification. You would be entitled to all suspended benefits after this Certification is provided to your insurer, if you are otherwise eligible for benefits.

Type: PDF
Last Updated: 2023-07-26

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Choice of Physician

When you are injured at work or become sick because of something that happened at work, the law gives you the right to choose your own doctor in any field or specialty of medicine for medical treatment.

Type: PDF
Last Updated: 2023-07-26

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