Corporate News


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

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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