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Simplifying the Work of Workers' Compensation



Indiana Workers' Compensation Information

  • Home
  • States
  • Workers' Compensation Information


  • State Telephone Numbers
  • State Forms
  • State Rules & Statutes

Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Indiana Workers' Compensation.


Indiana Workers' Compensation Telephone Directory


Worker's Compensation Board - Toll Free: 800-824-COMP

WCB Director of Compliance: 317-232-5922

WCB Second Injury Fund: 317- 232-3810

Fraud - Toll Free - Hot Line: 800-403-0864

Bureau of Rehabilitation Services: 877-241-8144

Rehabilitative Services - Mailing Address: 800-545-7763

Hearing District 1 - Case Coordinator: 317-233-3908

Hearing District 2 - Case Coordinator: 317-233-3908

Hearing District 3 - Case Coordinator: 317-232-3808

Hearing District 4 - Case Coordinator: 317-232-3808

Hearing District 6 - Case Coordinator: 317-233-5397

WC Board - Walk ins Phone # if Office is locked : 317-233-3009

Disabilities Ombudsman - General Information: 800-545-7763

Division of Disability & Rehabilitation: 800-545-7763

Manager of Information Technology: 317-233-0396

WC PPI Approval Division: 317-232-3825

WC PPI Approval Division: 317-232-3817

WC Board Chairman Linda Hamilton: 317-232-3811

WC Case Coordinator to Board Member Sandra O'Brien: 317-233-3908

WC Case Coordinator to Board Member A. James Sarkisian: 317-233-3908

WC Case Coordinator to Board Member Daniel Foote: 317-233-3009

WC Case Coordinator to Board Member Diane Parsons: 317-233-3009

WC Case Coordinator to Board Member Doug Meagher: 317-233-5397

WC Case Coordinator to Board Member Kyle Samons: 317-233-5397

WC PPI Approval Division Board Member: 317-232-3807

Occupational Safety Standards Commission: 317-232-2691

Department of Insurance - Commissioner Amy L. Beard - General Number: 317-232-2385

Records Division: 317-232-7225

Clerk of the Appellate Courts: 317-232-1930

WCB Executive Administrator Mary Taivalkoski: 317-232-3811

WCB Paralegal Darren Dye: 317-233-3384

WC Case Coordinator Beth Wallace: 317-233-3908

WCB Provider Fee/Intake Division: 317-232-5922

OSHA - Indiana State Plan: 317-232-2693

Forms & Publications


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Some "Revision Dates" may be displayed as part of the Description.

NOTICE

As of 2/19/2021, SF 36097 can be submitted to the Board electronically. Effective 4/19/2021, paper submissions of SF 36097 will no longer be accepted by the Board and those sent in or dropped off will be destroyed. Please update your current submission process from mailing in SF 36097 to online submission. **Please note that all forms marked by asterisks are required to be submitted online via the Forms Portal. Forms submitted to the Board in hard copy prior to being submitted online will be rejected.

(34401) First Report of Injury 1/02
(2118) Report of Attending Physician 8/11
(Form01042) Application for Review by Full Board 2/98
(18487) Application for Adjustment of Claim for Provider Fee 1/15
(52875) Provider Fee Request for Assistance 11/14
(29109) Application for Adjustment of Claim 6/05
(Form01043) Agreement to Compensation 3/09
(38911) Report of Temporary Total Disability (TTD) / Temporary Partial Disability (TPD) Termination / Reduction 1/14
(45442) Request for Assistance 5/06
(48557) Notice of Inability to Determine Liability/Request for Additional Time 7/12
(51247) Application for Second Injury Fund 2/03
(51702) Request for Prosthetic Repair or Replacement N/D
(34873) Agreement Between Parties for Lump Sum Payment 4/12
(18875) Agreement to Compensation Between the Dependents of Deceased Employee and Employer 5/10
(53913) Employee Waiver of Examination by Personal Physician 4/09
(54217) Notice of Suspension of Medical Benefits 3/13
(53914) Notice of Denial of Benefits 7/12
(53811) Request for Public Record 5/15
(36097) Notice for Workers' Compensation and Occupational Diseases Coverage 6/15
(34877) Subpoena 5/10
(Guidelines) Workers' Compensation Self Insurance Guidelines 2022
(si-1) Employer's Application for Permission to Carry Risk Without Insurance 2022
(si-2) Surety Bond 2003
(si-3) Certificate of Excess Insurance 2003
(si-4) Parental Indemnity Agreement 2003
(si-5) Employer's Request to Include a Subsidiary within its Self-Insurance Program 2012
(si-7) Trucker's Supplemental Application 2003
(12386-b) Certification of Workers" Compensation Carriers N/D
(55310) Certification of Insurance Carrier as to Number of Workers' Compensation Policies Written or Renewed 6/13
(45899) Application for Workers' Compensation Clearance Certificate 3/15
(55718) Application for Workers' Compensation Clearance Certificate (Spanish) 3/15
(TPAApplication) Service Company Application for Permission to Serve Indiana Self-Insured Employers N/D
(12386) Self-Insured Employer Certification N/D
  • Indiana Rules
  • Indiana Statutes

  • 631 IAC 1-1-2 Forms; publication and distribution of pamphlets

  • 631 IAC 1-1-3 Rules of practice in proceedings

  • 631 IAC 1-1-4 Pleadings in subsequent proceedings

  • 631 IAC 1-1-5 Pleadings and papers to be printed or typewritten; filing; service

  • 631 IAC 1-1-6 Plaintiffs

  • 631 IAC 1-1-7 Defendants

  • 631 IAC 1-1-8 Answers; affirmative defenses

  • 631 IAC 1-1-9 Disclaimer

  • 631 IAC 1-1-10 Expediting proceedings; notice of hearings; continuances

  • 631 IAC 1-1-11 Stipulations

  • 631 IAC 1-1-12 Testimony; depositions

  • 631 IAC 1-1-13 Pleadings or depositions in foreign language; translation

  • 631 IAC 1-1-14 Foreign plaintiffs; power of attorney

  • 631 IAC 1-1-15 Facts upon review; additional evidence; oral arguments

  • 631 IAC 1-1-16 X-ray films; admissibility

  • 631 IAC 1-1-17 Number of witnesses; challenging jurisdiction of board; insurance as proof of compliance

  • 631 IAC 1-1-18 Advice and information furnished by executive administrator

  • 631 IAC 1-1-19 Powers and duties of board's executive administrator

  • 631 IAC 1-1-20 Record of claims; electronic record

  • 631 IAC 1-1-21 Certified copies of records, orders, and transcripts

  • 631 IAC 1-1-22 Appeal to court of appeals

  • 631 IAC 1-1-23 Representing litigants before board

  • 631 IAC 1-1-25 Claims for fees; disputes

  • 631 IAC 1-1-26 Compensation agreements; failure to make payments

  • 631 IAC 1-1-27 Time period of payments; memorandum of termination

  • 631 IAC 1-1-28 Reports by employers

  • 631 IAC 1-1-28.5 Exempt entities

  • 631 IAC 1-1-29 Self-insurers; application for certification

  • 631 IAC 1-1-30 Request for certification of compliance

  • 631 IAC 1-1-31 Second injury fund

  • 631 IAC 1-1-32 Medical provider fee claims

  • 631 IAC 1-1-33 Fees for mediation by the board
  • Title 22 Indiana Worker's Comp Code

    Chapter 1. Worker's Compensation Board


  • 22-3-1-1 Creation; term of office; other positions; removal from office; compensation; executive administrator; expenses

  • 22-3-1-2 Jurisdiction

  • 22-3-1-3 Rules; powers and duties

  • 22-3-1-4 Schedule of attorney's fees

  • 22-3-1-5 Information sharing concerning construction workers misclassified as independent contractors
  • Chapter 2. Worker's Compensation: Application, Rights, And Remedies


  • 22-3-2-1 Repealed

  • 22-3-2-2 Mandatory compliance; burden of proof; exemptions

  • 22-3-2-2.1 Coverage for rostered volunteers

  • 22-3-2-2.3 Volunteer workers; services; medical benefits

  • 22-3-2-2.5 School to work student

  • 22-3-2-3 Repealed

  • 22-3-2-4 Preexisting contracts; continuance; minors

  • 22-3-2-5 Insurance; certificates authorizing carrying of risk without insurance; state self-insurance program

  • 22-3-2-6 Exclusive remedies

  • 22-3-2-7 Performance of statutory duties; application of law

  • 22-3-2-8 Qualifications; burden of proof

  • 22-3-2-9 Exempt employees; waiver of exemption; notice of acceptance

  • 22-3-2-10 Repealed

  • 22-3-2-11 Repealed

  • 22-3-2-12 Repealed

  • 22-3-2-13 Claims against third persons; subrogation; procedures

  • 22-3-2-14 Contractors; certificate of coverage; subrogation

  • 22-3-2-14.5 Independent contractor electing exemption from compensation provisions; filing statement; certificate of exemption

  • 22-3-2-15 Contracts, agreements, or rules do not relieve employers of obligations; voluntary settlement agreements; minors; approval; effect

  • 22-3-2-16 Claims for compensation; priorities

  • 22-3-2-17 Claims for compensation; assignment; creditor claims; child support income withholding

  • 22-3-2-18 Coal mining; application of law

  • 22-3-2-19 Interstate or foreign commerce; exemptions

  • 22-3-2-20 Place of accident

  • 22-3-2-21 Prior injuries; application of law

  • 22-3-2-22 Notice; worker's compensation coverage
  • Chapter 3. Worker's Compensation: Notice Of Injury; Treatment; Compensation Schedule; Payments


  • 22-3-3-1 Notice of injury; time

  • 22-3-3-2 Notice of injury; contents; signature

  • 22-3-3-3 Limitation of actions; radiation

  • 22-3-3-4 Medical treatment pending adjudication of impairment

  • 22-3-3-4.5 Repackaged drugs; maximum reimbursement amount

  • IC 22-3-3-4.7 Formulary; reimbursement for "N" drug

  • 22-3-3-5 Medical treatment; liability of estate; right to order payment; medical service provider claims; attending physician fees

  • 22-3-3-5.1 Collection of medical expense payments; civil penalties; good faith errors

  • 22-3-3-5.2 Billing review service standards

  • 22-3-3-6 Physical examination; physician's statement; autopsy

  • 22-3-3-7 Temporary disability benefits; installment payments; termination; overpayment

  • 22-3-3-7.5 Average weekly wages of public employee; determination

  • 22-3-3-8 Temporary total disability or total permanent disability; awards

  • 22-3-3-9 Temporary partial disability; awards

  • 22-3-3-10 Injuries schedule

  • IC 22-3-3-10.5 Permanent partial impairment agreement; supporting documentation; payment of compensation; civil penalty

  • 22-3-3-11 Partial disability; refusing employment; notice

  • 22-3-3-12 Subsequent permanent injuries; aggravation; awards

  • 22-3-3-13 Second injury fund; employee compensation; employer assessments; penalties

  • 22-3-3-14 Subsequent injuries; two awards

  • 22-3-3-15 Subsequent injuries; awards; extending period of payment

  • 22-3-3-16 Death while receiving awards; dependents; payment

  • 22-3-3-17 Death benefits

  • 22-3-3-18 Death resulting from injuries; award; payment to dependents

  • 22-3-3-19 Presumptive dependents; termination of dependency

  • 22-3-3-20 Total or partial dependents; eligibility; termination

  • 22-3-3-21 Burial expenses

  • 22-3-3-22 Awards; computation

  • 22-3-3-23 Mistake in payments; deductions; payments to state employees

  • 22-3-3-24 Payments; time of payment

  • 22-3-3-25 Lump sum payments; minors; interest rate

  • 22-3-3-26 Lump sum payments; trustees

  • 22-3-3-27 Jurisdiction; modification of award

  • 22-3-3-28 Children and minors; direct payments

  • 22-3-3-29 Injured employee or dependent under guardianship

  • 22-3-3-30 Incompetent persons; limitation of actions

  • 22-3-3-31 Joint service of two or more employers; apportionment of award

  • 22-3-3-32 Construction of article
  • Chapter 4. Worker's Compensation: Administration And Procedures


  • 22-3-4-1 Industrial board; office space; furniture and supplies; meetings

  • 22-3-4-2 Rules; subpoenas; service; hearings

  • 22-3-4-3 Inspection of records; confidential information; destruction of records

  • 22-3-4-4 Awards; private agreements; approval

  • 22-3-4-4.5. Mediation of claims; fees and charges

  • 22-3-4-5 Disputes; hearings

  • 22-3-4-6 Disputes; summary proceedings

  • 22-3-4-7 Disputes; administrative review

  • 22-3-4-8 Disputes; awards; appeals

  • 22-3-4-9 Contracts; private agreements; appeals

  • 22-3-4-10 Actions and proceedings; costs

  • 22-3-4-11 Medical examination; physician or surgeon

  • 22-3-4-12 Rates and charges; attorney's fees; payment

  • 22-3-4-12.1 Bad faith in adjusting or settling claim for compensation; awards; attorney's fees

  • 22-3-4-13 Reports of injuries and deaths; violations of article

  • 22-3-4-14 Awards; termination; reports

  • 22-3-4-15 Civil penalties; schedule
  • Chapter 5. Worker's Compensation: Insurance Requirements


  • 22-3-5-1 Requirements; self-insurance; security; fees

  • 22-3-5-2 Termination of insurance; filing fees; evidence of compliance

  • 22-3-5-2.5 Proof of compliance; notice; civil penalty; Internet posting

  • 22-3-5-3 Self-insurance; certificates; revocation

  • 22-3-5-4 Substitute system of insurance

  • 22-3-5-5 Policy provisions; failure to pay claims

  • 22-3-5-5.5 Deductibles and co-insurance

  • 22-3-5-6 Supplemental administrative fund
  • Chapter 6. Worker's Compensation: Miscellaneous Provisions


  • 22-3-6-1 Definitions; exemptions

  • 22-3-6-2 Mutual insurance associations and reciprocal or interinsurance exchanges

  • 22-3-6-3 Compliance with former law
  • Chapter 7. Worker's Occupational Diseases Compensation


  • 22-3-7-1 Repealed

  • 22-3-7-2 Applicability; burden of proof; police and firefighter coverage

  • 22-3-7-2.5 School to work student

  • 22-3-7-3 Waiver of exemption from act by employer; notice of acceptance; filing

  • 22-3-7-4 Repealed

  • 22-3-7-5 Coal mining; application of law

  • 22-3-7-6 Exclusive remedies

  • 22-3-7-7 Statutory duties; application of law

  • 22-3-7-8 Place of exposure; foreign states or foreign countries

  • 22-3-7-9 Definitions; applicability of chapter; exemptions

  • 22-3-7-9 Definitions; applicability of chapter; exemptions

  • 22-3-7-9.2 "Violation of the child labor laws of this state"

  • 22-3-7-10 Definitions; course of employment

  • 22-3-7-10.5 Average weekly wages of public employee; determination

  • 22-3-7-11 Death benefits; payment

  • 22-3-7-12 Dependents; classification

  • 22-3-7-13 Presumptive dependents; termination of dependency

  • 22-3-7-14 Dependents; total or partial dependents; relatives; termination of dependency

  • 22-3-7-15 Death benefits; burial expenses

  • 22-3-7-16 Disablements; awards

  • 22-3-7-17 Medical attendance and treatment; prosthetic devices; emergency treatment; liability to providers; medical service provider claims

  • 22-3-7-17.1 Collection of medical expense payments; civil penalties; good faith errors

  • 22-3-7-17.2 Billing review service standards

  • 22-3-7-17.4 Repackaged drugs; maximum reimbursement amount

  • IC 22-3-7-17.6 Formulary; reimbursement for "N" drug

  • 22-3-7-18 Awards; lump sum payments

  • 22-3-7-19 Awards; computation; average weekly wages

  • 22-3-7-20 Physical examinations; board and lodging; traveling expenses; reports; autopsy

  • 22-3-7-21 Awards; disqualification

  • 22-3-7-22 Industrial board; expenses; office space; meetings

  • 22-3-7-23 Jurisdiction; administration

  • 22-3-7-24 Rules; hearings; subpoenas; production of books and papers; attorney's fees

  • 22-3-7-25 Forms and literature; reports; confidential information

  • 22-3-7-26 Disputes; settlement

  • 22-3-7-27 Awards; modification; hearings; appeals; investigations

  • 22-3-7-28 Destruction of records

  • 22-3-7-29 Priorities and preferences; assignment; claims of creditors; child support income withholding

  • 22-3-7-30 Awards; private agreements; filing

  • 22-3-7-31 Waiver of compensation; approval; silicosis or asbestosis

  • 22-3-7-32 Actions and proceedings; notice; limitation of actions

  • 22-3-7-33 Exposure; presumptions; joint employers

  • 22-3-7-34 Insurance; self-insurance; exemptions

  • 22-3-7-34.3 Proof of compliance; notice; civil penalty; Internet posting

  • 22-3-7-34.5 Independent contractors seeking exemption from chapter; filing statement; fees; certificate of exemption

  • 22-3-7-35 Contract relieving employer of obligations

  • 22-3-7-36 Third parties; actions to recover damages; subrogation; limitation of actions

  • 22-3-7-37 Reports of disablements; penalties; venue

  • 22-3-7-38 Application of law
  • Chapter 8. Representation Before Worker's Compensation Board


  • 22-3-8-1 Attorneys; qualifications

  • 22-3-8-2 Attorneys; registration; oath; records
  • Chapter 9. Employer Liability


  • 22-3-9-1 Personal injuries or death; damages

  • 22-3-9-2 Personal injuries or death; contributory negligence; burden of proof

  • 22-3-9-3 Personal injuries or death; assumption of risk; safe place to work; defective tools

  • 22-3-9-4 Personal injuries or death; survival of actions

  • 22-3-9-5 Contracts; rules and regulations; exemption from liability; setoff

  • 22-3-9-6 Wrongful death damages; amount

  • 22-3-9-7 Assumption of risk; negligence; contributory negligence; questions of fact

  • 22-3-9-8 Limitation of actions

  • 22-3-9-9 Definitions

  • 22-3-9-10 Application of law

  • 22-3-9-11 Supplemental remedies; common law rights
  • Chapter 10. Ban On Employer Waiver Of Liability


  • 22-3-10-1 Negligence; employer; liability for damages

  • 22-3-10-2 Negligence; third persons; liability for damages

  • 22-3-10-3 Negligence; employer; liability for damages; contract between employee and third person
  • Chapter 11. Residual Asbestos Injury Fund


  • 22-3-11-1 Creation; administration; use of fund

  • 22-3-11-2 Assessments; deposit in fund

  • 22-3-11-3 Repealed

  • 22-3-11-4 Repealed

  • 22-3-11-5 Expert medical testimony

  • 22-3-11-6 Repealed
  • Chapter 12. Vocational Rehabilitation


  • 22-3-12-1 Entitlement to vocational rehabilitation services

  • 22-3-12-2 Report of injury; copy to central office

  • 22-3-12-3 Report of injury; copy to local office

  • 22-3-12-4 Explanation of services; eligibility determination; plan implementation

  • 22-3-12-5 Construction of chapter; employee's benefits
  • Title 27 Insurance


  • 27-7-2-1 Repealed

  • IC 27-7-2-1.1 Purposes of chapter

  • IC 27-7-2-1.2 Insurers and underwriters subject to chapter

  • IC 27-7-2-2 Definitions

  • IC 27-7-2-3 Worker's compensation rating bureau; membership

  • IC 27-7-2-3.1 Duties of bureau

  • IC 27-7-2-4 Rate filings; notice

  • IC 27-7-2-5 Management of bureau

  • IC 27-7-2-6 By-laws of bureau

  • IC 27-7-2-7 Resolution of tie votes

  • IC 27-7-2-8 Membership in bureau

  • IC 27-7-2-9 Charges and expenses of bureau; apportionment; review

  • 27-7-2-10 Repealed

  • IC 27-7-2-11 Approval of classifications, premiums, or rates; consultations with worker's compensation board; duty of board to furnish information

  • IC 27-7-2-12 Representative of department; appointment; powers and duties

  • 27-7-2-13 Repealed

  • 27-7-2-14 Repealed

  • IC 27-7-2-15 Approval of system of schedule rating

  • 27-7-2-16 Repealed

  • 27-7-2-17 Repealed

  • IC 27-7-2-18 Exclusion of physical impairment of employees in rate making

  • 27-7-2-19 Repealed

  • IC 27-7-2-20 Adherence to approved rules, forms, plans, and systems; annual reports

  • IC 27-7-2-20.1 Minimum premiums and rates

  • IC 27-7-2-20.2 Minimum premiums, rates, and supplementary rate information; filing; approval; proof of notice; public inspection

  • IC 27-7-2-20.3 Minimum premiums or rates; disapproval

  • IC 27-7-2-20.4 Arrangements in restraint of trade; presumption; subsidiary companies

  • 27-7-2-21 Repealed

  • 27-7-2-22 Repealed

  • 27-7-2-23 Repealed

  • IC 27-7-2-24 Appointment of resident agent for service of process

  • IC 27-7-2-25 Annual license of rating bureau

  • IC 27-7-2-26 Effect of chapter on mutual insurance associations and reciprocal associations

  • IC 27-7-2-27 Jurisdiction of courts of Marion County; review

  • IC 27-7-2-28 Duty to insure and accept certain rejected risks

  • IC 27-7-2-28.1 Assigned risk plan; administration; filing; approval; modification or elimination by general assembly

  • IC 27-7-2-28.2 Examination of records; costs

  • IC 27-7-2-29 Rejected risks; designation of insurer; reinsurance

  • IC 27-7-2-30 Rules; adoption

  • IC 27-7-2-31 Loss of coverage for nonpayment of premiums; report of conditions precluding insurance; coverage pending decision

  • IC 27-7-2-32 Considerations in designating insurer to assume rejected risk; review of reasons

  • IC 27-7-2-33 Designated insurer carrying rejected risk; additional inspection; renewal rates

  • IC 27-7-2-34 Information concerning rejected risks; automatic insurance

  • IC 27-7-2-35 Record of rejected risks referred by bureau to members; effect of writing rejected risk as regular business

  • 27-7-2-36 Repealed

  • IC 27-7-2-37 Cancellation of rejected risk coverage; grounds; effect

  • IC 27-7-2-37.5 Refund of dividends, savings, or unabsorbed premium deposits

  • IC 27-7-2-38 Violations; penalties; suspension or revocation of license

  • IC 27-7-2-39 Appointment and compensation of personnel; appropriation

  • IC 27-7-2-40 Confidential data; data sharing with department or worker's compensation board

  • 27-7-3-2 Definitions

  • 27-7-3-22 Closing protection letter; fee

  • 27-7-5-2 Uninsured and underinsured motorist coverage; required coverage; rejection; exemptions




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