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WorkersCompensation.com Announces Additional State Forms Added To FlashForm SSL Forms Auto-Complete System

01 Sep, 2010 WorkersCompensation.com

                               

Sarasota, FL (CompNewsNetwork) - WorkersCompensation.com announced today that over 100 new state forms were added to it's FlashForm SSL Form Auto-Completion Sysytem in the month of August. This brings the total of new state forms added to the system sincce June 1st to 180. There are currently almost 700 forms available for auto-population to FlashForm SSL users.

FlashForm SSL was launched in 2009, and is a service that auto-completes required state workers' compensation forms directly from claims software enabled to interface with the system. Robert Bennett, VP of Systems Development for WorkersCompensation.com said, "We anticpate that we will eventually have approximately 1,000 forms in the FFSSL system, although any of the more than 3,000 forms within our library could be added, if clients request them". 

The company anticipates  reaching the 1,000 form goal in the 1st quarter of 2011.

Forms added in the last 3 months are:

 

State Form Name
AK Physician's Report 
AK Medical Summary 
AK Affidavit Of Readiness For Hearing 
AK Petition To join SIF And Claim For Reimbursement 
AK Notice of Possible Claim Against the Second Injury Fund 
AK Petition 
AK Subpoena 
AK Request for Release of Information 
AK Public Records Request 
AK Fishermen's Fund Physician's Report 
AK Second Independent Medical Evaluation 
AK Eligibility Evaluation Checklist 
AK Offer of Alternative Employment 
AK Request For Cross-examination 
AK Affidavit Of Compensation Rate Less Than $154
AK Waiver of Reemployment Benefits 
AK Release of Medical Information 
AK Release of Counseling, Psychol, Psych, or Alcohol/Drug/Substance Abuse Txmt Records
AK Carpal Tunnel Syndrome Questionare 
AK Vessel Owner (Employer) 
CA Petition for Change of Primary Treating Physician 
CA Medical mileage expense form in English/Spanish - for travel between 7/1/06 and 1/1/07
CA Medical mileage expense form in English/Spanish - for travel on or after 1/1/07
CA Medical Mileage Expense Form 
CA Application for Adjudication of Claim 
CA Declaration of Readines to Proceed - Expedited Hearing (Trial) 
CA Declaration of Readiness to Proceed 
CA Answer To Application For Adjudication Of Claim 
CA Request for Consultative Rating 
CA Compromise and release 
CA Stipulation and award and/or order 
CA PreTrial Conference Statement 
CA Stipulations with request for award 
CA Minutes of Hearing/Order/Order and Decision on Request for Continuance/ Order Taking Off
CA Petition for Commutation of Future Payments 
CA Petition for Reconsidertion 
CA Notice and Request for Allowance of Lien 
CA Petition for Appointment of Guardian ad Litem and Trustee 
CA Petition to Reopen 
CA Stipulations With Request For Award 
CA Stipulations With Request For Award (Death Case) 
CA Compromise And Release 
CA COMPROMISE AND RELEASE (Dependency claim) 
CA Third Party Compromise And Release 
CA Document Cover Sheet 
CA Minutes Of Hearing 
CA Information Guidelines For Submission Of Settlement Documents 
CA Primary Treating Physican's Progress Report 
CA Primary Treating Physican's Permanent and Stationary Report 
CA Primary Treating Physician's Permanent and Stationary Report 
CA Objection To Treating Physician's Recommendation For Spinal Surgery 
CA Cover page for medical provider network 
CA Notice of medical provider network plan modification
CA Employee's Permanent Disability Questionnaire 
CA Request for Summary Rating Determination (of AME's or QME's Report) 
CA Request for Summary Rating Determination (of Primary Treating Physician's Report) 
CA Request for Reconsideration of Summary Rating by the Administrataive Director 
CA Request For Consultative Rating 
CA Apportionment 
CA Notice of Options Following Permanent Disability Rating 
CA Employee's Request for Information Pemanent Disability Rating 
CA Request for Conclusion 
CA Declination for Date Of Injury's pre 1/1/90
CA Treating Physician Report of Disability 
CA Description of Job Duties 
CA Notice of Offer of Modified or Alternate Work 
CA Rehabilitation Plan 
CA Request for Dispute Resolution 
CA Notice of Termination 
CA Declination for Date Of Injury's 1-1-90 - 12-31-93 (12/02)
CA Declination for Date Of Injury's (1/94)
CA Evaluation Summary 
CA Progress Report 
CA Settlement Prospective of Voc Rehab Services 
CA Noticia De Oferta De Trabajo Regular 
CA Request for Reimbursement of Accommodation Expenses 
CA Request for Reimb of Accommodation Expenses For injuries on or after July 1, 2004 
CA Noticia De Oferta De Trabajo Modificado O Alternativo 
CA Request For Dispute Resolution Before Administrative Director 
CA Supplemental Job Displacement Nontransferable Training Voucher Form 
CA Utilization Review Complaint Form 
CA Petition for Permission to Negotiate a Section 3201.7 Labor-Management Agreement 
CA Request for Public Records 
CA Report of Suspected Medical Care Provider Fraud 
CA Application For Subsequent Injuries Fund Benefit 
CO Physician's Report of Workers' Compensation Injury 
CO Notice of Failed IME Negotiation 
CO Request/Notification for Follow-up IME 
HI Physician's Report
HI Response to Application for Hearing
IA Application and Consent Order under 85.21 
IA Dispute Resolution Conference Report 
IA Release of Information 
IA Hearing Report and Order Approving Same 
IA Prehearing Conference Report 
IA Medical Transmittal Form 
IA Payment Activity Report 
IA Combination Settlement 
IA Contingent Settlement 
ID Reimbursement for Health Care Travel Expenses
ID Answer To Complaint
ID Subpoena
ID Rehabilitation Division Referral Form
ID Notice of Intent to File Complaint Against Industrial Special Indemnity Fund
ID Mediation Request Form
KS Settlement Agreement Final Receipt And Release Of Liability 
KS Application For Hearing 
KS Application For Preliminary Hearing 
KS Request For Workers Compensation Records 
KS Pre-Trial Stipulations 
KS Injured Worker Documentation 
KS Request for Workers Compensation Records
LA Request for Social Security Benefits Information 
LA Motion for Recognition of Right to Social Security Offset 
LA Order Recognizing Right to Social Security Offset 
LA Subpoena for Deposition N/D 
LA Employer Report of Injury/Illness 
LA Disputed Claim for Compensation 
LA Request for Compromise of Lump Sum Settlement 
LA Reporte Mensual De Ganancias Del Empleado
LA Cost Containment Application 
LA Employee Certificate of Compliance 
LA Employer Certificate of Compliance 
LA Certificado De Conformidad Del Trabajador 
LA Employee's Quarterly Report of Earnings 
LA Special Reimbursement Consideration Appeal 
LA Notice of Claim with Second Injury Fund 
LA P & I Form 
LA Settlement Evaluation 
LA Settlement Evaluation-Permanent and Total 
LA Interpreter/Ada Accomodations 
LS Request for Examination and/or Treatment
LS Approval of Compromise of Third Person Cause of Action
LS Notice of Employee's Injury or Death
LS Employers First Report of Injury or Occupational Illness
LS Request for Earnings Information
MI Redemption Order 
MI Provider's Report of Claim & Request for Medical Payment 
MI Worker's Settlement Statement 
MI Declaración Del Acuerdo Del Trabajador 
MI Application for Certification of a Carrier's Professional Health Care Review Program 
MI Group Self-Insurance Notice of Acceptance of Membership 
MI Notice of Termination of Membership 
MI Carrier's Explanation of Benefits 
MO Workers' Compensation Subpoena 
MO Workers' Compensation Subpoena Duces Tecum 
MO Workers' Compensation Subpoena For Deposition 
MO Workers' Compensation Subpoena Duces Tecum For Deposition 
MO Authorization to Inspect and/or Copy Medical Records 
MO Request by a Health Care Provider for Case Status 
MO Answer to Application for Payment of Additional Medical Fees 
MO Stipulation for Compromise Settlement 
MO Payment of Additional Reimbursements of Medical Fees 
NM Subpoena or Subpoena Duces Tecum 
NM Worker's Authorization For Disclosure Of Protected Health Information
NM Autorización De Los Trabajadores Para La Revelación De Información Médica 
OK Employers' First Notice of Accidental Injury and Claim for Compensation.  
OK Claim form. 
OK Designation of Service Agent. 
OK Motion to Set for Trial. 
OK Response to Request for Payment of Charges for Medical or Rehabilitative Services.  
OK Request for Payment of Charges for Medical or Rehabilitative Services/ Notice of Appeal of Administrative Order. 
OK Proof Of Loss For Spouse And Children.  
OR Notice of Closure 
OR Preferred Worker Worksite Modification Agreement (Limited to $2,500) 
OR Insurer Request for Reconsideration 
OR Insurer Notice of Closure Worksheet (Dates of injury prior to January 1, 2005) 
OR Insurer Notice of Closure Worksheet (Dates of injury on or after January 1, 2005) 
OR SUBPOENA To Compel Attendance and Testimony at Hearing 
OR SUBPOENA To Compel Production of Documents or Objects other than Ind Ident Health Info
OR SUBPOENA To Compel the Production of Individually Identifiable Health Information 
SC Annual Minor Medical Report 
SC Employee's Notice of Claim and/or Request for Hearing 
SC Employee's Notice of Claim and/or Request for Hearing (Death Case) 
SC Employers Answer to Request for Hearing, Death Case 
SC Occupational Disease Waiver 
SD Statement of Weekly Earnings
SD Petition For Grievance
UT Application for Hearing
UT Medical Care Provider Application for Hearing

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