Federal Wage and Hour Poster

Fire Boss Study Guide

Form 043 – Attending Physician’s Statement

Form 044 – Employee’s Notification of Intent to Leave Locality or State, and to Change Doctor or Hospital

Form 089 – Employee Notification of Denial or Partial Denial of Claim

Form 100 – Injured Workers’ Rights and Responsibilities

Form 100 – Injured Workers’ Rights and Responsibilities (Spanish)

Form 102 – Application to Change Doctors

Form 122 C – Insurance Carrier/Self Insured Employer First Report of Injury or Illness

Form 122 E – Employers First Report Of Injury or Illness

Form 130 – Insurance Company’s and Self Insurer’s Final Report of Injury and Statement of Total Losses

Form 134 Application for Lump Sum or Advance Payment