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There were 11 articles found in this category:
  1. questionFirst Report of Injury or Illness Form
    When an employee notifies you that an injury has occurred, it is your department’s responsibility to obtain all pertinent information needed for completion of the injury report (IA-1 form). Complete the first report of injury or illness form immediately and e-mail it Blaire Bushart at bbus ...

  2. questionLost Time and Return to Work Form
    Attached below is the WCF-1 form.

  3. questionFraudulent Claim Acknowledgement
    Please see attachment below.

  4. questionNoticed of Second Designated Physician Form

  5. questionNotice of Designated Physician Form

  6. questionProvider Introductory Letter

  7. questionRequest for Payment for Services or Reimbursement for Compesable Services

  8. questionCommonwealth of Kentucky-CCMSI, Inc.-Report of Medical Status Report

  9. questionWorkers' Compensation Sick Leave Form

  10. questionWorkmans' Compensation Prescription Program Form

  11. questionMedical Waiver and Consent Form