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Maryland Form Center


Welcome to the most extensive library of workers' compensation forms available anywhere. Almost 3,000 forms are available for your immediate download and use. Our forms, all of which have been custom programmed by WorkersCompensation.com for Type & Save functionality, are available for individual purchase below.

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(IA-1) First Report of Injury or Illness - 1/02
(A01) Insurance Information Report - 8/08
(A04) Parental Guarantee and Board Resolution - 9/06
(A05) Application for Self-Insurance and Instructions - 9/06
(A05s) Self-Insured Employers Application to Add a Subsidiary Form A-05S - 1/07
(A07) Continuous Surety Bond Form - 8/03
(A08) Irrevocable Letter of Credit - 9/06
(A09) Memorandum of Understanding Form - 7/03
(A25) Authorization for Release of Medical Information - 6/05
(areport) Accident Investigation/Reporting and Injured Worker Form - 3/01
(areport-sp) Accident Investigation/Reporting and Injured Worker Form (Espanol) - 2/01
(attyreg) Attorney Registration/Change Form - 5/07
(C1) Employee Claim Form - Claimant must use original C1 form here:
http://www.wcc.state.md.us/WFMS/C1_WebForms.html
(C2) Statement of Wage Information - 6/08
(C3) Claim Amendment - 10/07
(C06) Insurers Termination of Temporary Total Disability Benefits - 10/09
(C15R) Inclusion Form - 11/02
(C16R) Exclusion Form - 11/02
(C18) Certification of Funeral Expenses - 10/07
(C19) Claim For Funeral Benefits Only - 7/08
(C24) Notice For Employees Poster - 11/07
(C24R) Request to Enter Appearance of Counsel - 9/03
(C25R) Request to Strike Appearance of Counsel - 9/03
(C26R) Request to Enter Appearance of Counsel for Employer / Insurer - 9/03
(C35) Dependents Claim for Death Benefits - 10/07
(C51) Claim for Medical Services - 3/08
(C90R) Request For Document Correction - 2/09
(eC50R) Stipulation for Advancement - 9/06
(FRS) Financial Reporting System Selected Data From Audited Financial Statements - N/D
(H05) Claimants Affidavit In Support Of Settlement - 9/03
(h08) Subpoena/Subpoena Duces Tecum - 9/05
(h08-noi) Notice of Intent to Subpoena Medical Records & Certificate of Service - 8/05
(h08-ots) Objection to Subpoena of Medical Records - 8/05
(H09) Agreement on Final Compromise and Settlement - 3/06
(H07) Guide Form for Proposed Final Compromise and Settlement Agreement - 1/06
(H10) Application for Lump Sum - 9/03
Cover Sheet For Action On Claims On Appeal - 6/08
(H12) Request for a Hearing on Previously Withdrawn Issues - 2/07
(H22R) Claimant Request for Change of Address - 3/04
(h23r) Request for Employer Designee to Receive Notice of Employee Claims - 6/09
(H24M) Controversion of Medical Claim - 1/08
(H24R) Issues Form - required with Forms H26R, H30R - 12/00
(H25R) Request for Action on Filed Issues - 2/07
(H26R) Request for Emergency Hearing - 9/03
(H27R) Request for Rehearing - 9/03
(H28R) Request for Continuance or Postponement of Hearing - 1/08
(H29R) Request for Postponement of Emergency Hearing - 9/03
(H30R) Request for Reconsideration/Modification - 7/05
(H31R) Employer/Insurer Request for Change of Address - 3/04
(H32) Controversion of Medical Claim - 10/09
(H32R) Request to Implead a Party in Uninsured Employer\'s Fund - 9/03
(h33r) Request to Implead a Party -10/04
(H34) Stipulation of Parties and Award of Compensation - 9/03
(H35R) Request for a Hearing for Referral to Maryland Insurance Fraud Division - 2/07
(H37) Claimants Questionnaire - 8/07
(H38) Uninsured Employer Employer Questionnaire - 5/06
(H44) Claimant’s Consent To Pay Attorney And Doctor Fees - 10/07
(settle) Agreement Of Final Compromise And Settlement - 3/06
(sole prop) Sole Proprietor Status as a Covered Employee Form - 9/03
(VR1) Stipulated Rehabilitation Plan - 11/06
(VR2) Vocational Rehabilitation Closure Report - 11/00
(VR7) Initial Rehabilitation Services Referral Form - 3/00
(VR10) Rehabilitation Service Plan - 12/00
(VR13) Notice of Vocational Rehabilitation Plan Controversion or Acceptance - 8/6/08