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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
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Notice_of_Second_Designated_Physician.pdf

  5. questionNotice of Designated Physician Form
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Notice_of_Designated_Physician.pdf

  6. questionProvider Introductory Letter
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Provider_Introductory_Letter.pdf

  7. questionRequest for Payment for Services or Reimbursement for Compesable Services
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Request_for_Payment_for_Services.pdf

  8. questionCommonwealth of Kentucky-CCMSI, Inc.-Report of Medical Status Report
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Commonwealth_of_KY-CCSMI,%20Inc._Report_of_Medical_Status.pdf

  9. questionWorkers' Compensation Sick Leave Form
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Workers_Compensation_Sick_Leave_Form.pdf

  10. questionWorkmans' Compensation Prescription Program Form
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Prescription_Program_Form.pdf

  11. questionMedical Waiver and Consent Form
    http://campus.murraystate.edu/administ/hr/benefitforms/Workers'Comp/Medical_Waiver_and_Consent.pdf