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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