Virginia Workers' Compensation Forms
- Worker Compensation Forms - Claim For Benefits
- Worker Compensation Forms - Employer Application For Hearing (Form 5a)
- Worker Compensation Forms - Agreement To Pay Benefits (Form 4)
- Worker Compensation Forms - Report Of Minor Injuries (Form 45-A)
- Worker Compensation Forms - Report Of Medical Costs (Form 45-G)
- Worker Compensation Forms - Termination Of Wage Loss Award (Form 46 -Formerly Agreed Statement Of Fact)
- Worker Compensation Forms - Wage Chart Form 7a)
- Worker Compensation Forms - Supplementary Report (Form Vwc 3a, Rev 9/99)
- Worker Compensation Forms - Supplementary Report For Fatal Accidents (Form Vwc 3b)
- Worker Compensation Forms - Physician Report(Form 6)
How To File a Workers Compensation Claim
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Fairfax, VA
866-853-6088
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