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South Dakota 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.

Try a Forms Membership! If you have an ongoing need for multiple forms, and want complete and unrestricted access to our entire 3,000 "Type & Save" Forms Library, you may register for immediate access here. Annual subscribers to this service get the benefit of our forms updating system, making sure the forms they use are the most current available.

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(wcfri) First Report of Injury - Employer's form - 2/08
General Instructions for First Report of Injury (Backside of FRI) - 4/04
(106) Request for Extension of Time - 6/03
(Weekly Earnings) Statement of Weekly Earnings - N/D
(107) Monthly Payment Report - 3/04
(110) Calculation of Compensation - 6/03
(111) Memorandum of Payment for Permanent Partial Disability - 6/03
(112) Finger Amputation Impairment Form - 4/05
(113) Memorandum of Payment for Rehabilitation - 6/03
(cm) Case Management Compliance Certification - 6/03
(indcon) Independent Contractor Verification Application
(mcapp03) Case Management Plan Certification Application - N/D
(mediation) Mediation Request - N/D
(hearing) Petition for Hearing - N/D
(boss-qa) Workers' Compensation - Employer Q & A - N/D
(worker-qa) Workers' Compensation - Employee Q & A - N/D
(AssumptionofSelf-InsuranceObligations) Assumption of Self-Insurance Obligations - N/D
(CMDisputeResolution) CM Dispute Resolution Generic - N/D
(IrrevocableLetterofCredit) Irrevocable Letter of Credit - N/D
(IrrevocableTrustAgreement) Irrevocable Trust Agreement - N/D
(PetitionForDecertification) Petition For Decertification - N/D
(PetitionForElection) Petition For Election - N/D
(PetitionForGrievance) Petition For Grievance - N/D
(PetitionForUnitDetermination) Petition For Unit Determination - N/D
(PFHOULP2) Petition For Hearing On Unfair Labor Practice - N/D
(RequestForConciliation) Request For Conciliation - N/D
(RequestforExtensionOfTime) Request for Extension Of Time - 6/03
(RequestForFactFinding) Request For Fact Finding - N/D
(Self-InsuranceAggregateSuretyBond) Self-Insurance Aggregate Surety Bond - N/D
(Self-InsuredEmployersPlanforManagedCare) Self-Insured Employers Plan for Managed Care - N/D
(SmallClaimsPetitionForHearing) Small Claims Petition For Hearing - N/D
(ThirdPartyAdministratorApplicationPacket) Third Party Administrator Application Packet - 7/01
(TrustOperationalAgreement) Trust Operational Agreement - N/D
(WCSelf-InsuranceApplication) WC Self-Insurance Application - N/D