Nebraska Workers' Compensation Information



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 Nebraska Workers' Compensation.

Nebraska Workers' Compensation Telephone Directory


WC Court Mailing Address: 402-471-6468

WC Court - Toll Free: 800-599-5155

Vocational Rehabilitation Specialist: 402-471-9743

Clerk of the Court: 402-471-6466

Fraud: 402-471-2201

Records Request - Toll Free: 800-599-5155

Records Request: 402-471-6468

Dispute Resolutions - Administrative Office: 402-471-3025

Dispute Resolutions - Toll Free: 800-599-5155

Vocational Rehabilitation Manager: 402-471-6551

Vocational Rehabilitation Specialist: 402-471-3605

Regulatory Program Manager: 402-471-2953

WC Self-Insurance Auditor: 402-471-6458

Bureau of Labor Statistics: 402-471-6523

Appeals: 800-599-5155

Fraud (In-State): 877-564-7523

Assigned Risk Plan Information: 402-471-4647

Deputy Clerk: 402-471-2543

Judicial Assistant to Presiding Judge Daniel R. Fridrich: 402-595-3900

Judicial Assistant to Judge James R. Coe: 402-595-3900

Judicial Assistant to Judge Michael Fitzgerald: 402-471-3924

Judicial Assistant to Judge John R. Hoffert: 402-471-3923

Judicial Assistant to Judge Thomas E. Stine: 402-471-3923

Judicial Assistant to Judge Julie A. Martin: 402-595-3900

Judicial Assistant to Judge Dirk V. Block: 402-471-3924

Judicial Assistant - Toll Free - for all Judges: 800-599-5155

Office of the Court Administrator: 402-471-3602

Information Technology Section Manager: 402-471-2976

Mediation by Video Conference Request: 402-471-3025

Public Information Manager: 402-471-6455

Assigned Risk Contact Information: 800-842-9346

Judicial Assistant to Presiding Judge Daniel R. Fridrich - Toll Free: 800-599-5155

Information Technology Manager: 402-471-2976

WC Court Judge Dirk V. Block: 402-471-3924

WC Court Judge Dirk V. Block - Toll Free Number: 800-599-5155

WC Court Judge James R. Coe: 402-595-3900

WC Court Judge James R. Coe - Toll Free: 800-599-5155

WC Court Judge J. Michael Fitzgerald : 402-471-3924

WC Court Judge J. Michael Fitzgerald - Toll Free Number: 800-599-5155

NDOL Safety Consultation: 402-471-4717

Department of Insurance Director Eric Dunning - Main Number: 402-471-2201

Department of Insurance: 402-471-2201

OSHA -Omaha Area Ofc. - Federal OSHA covers private Employers/Employees in NE : 402-553-0171

Forms & Publications


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

(form1) First Report of Alleged Occupational Injury or Illness 12/11
(form4) Subsequent Report 6/06
(petition) Petition & Addendum N/D
(motionpro) Motion to Continue Trial - Order of Continuance N/D
(int-sel-aff) Interpreter Selection Affidavit 2/10
(settlement application) Application for an Order Approving Lump Sum Settlement N/D
(proposed order) Proposed Order Approving Lump Sum Settlement N/D
(liability release) Release of Liability N/D
(release medical) Release of Liability: Leaving Future Medical Liability Open N/D
(idrform) Informal Dispute Resolution Request Form 2017
(idr info sheet) Information Sheet: Informal Dispute Resolution and Mediation 7/14
(proseinfo) Information for Claimants Not Represented by an Attorney 4/18
(proseinfo sp) Information for Claimants Not Represented by an Attorney (Spanish) 4/18
Information Sheet - Choosing a Doctor for a Work-Related Injury 11/99
Information Sheet - Choosing a Doctor for a Work-Related Injury (Spanish) 11/99
(form50) Choice of Doctor 3/18
(form50-sp) Choice of Doctor (Spanish) 3/18
(form62) Independent Medical Examiner Application for Appointment 3/09
(form63-1) Request for Independent Medical Examiner 4/08
(form67-2) Notice of Agreement to use a Named Independent Medical Examiner 4/08
(form12) Record of Compensation Insurance 6/95
(form12p) Record of Compensation Insurance - Intergovernmental Risk Management Pool 11/06
(vr37e1) Case Closure Report- No Plan Proposed 6/16
(vr37e2) Case Closure Report - Plan or Plans Proposed 6/16
(vr37e3) Plan Closure Report 6/16
(vr37e4) Follow-Up Employment Status Report 6/16
(vr37e4sp) Follow Up Employment Status Report (Spanish Version) 2/19
(vr39) Application for Certification Vocational Rehabilitation 8/14
(vr39a) Application for Renewal of Certification Vocational Rehabilitation 8/14
(vr42) Vocational Rehabilitation Counselor Designation 6/13
(vr42b) Vocational Rehabilitation Counselor Appointment Request 8/17
(vr42c) Agreement for the Selection of a Vocational Rehabilitation Counselor 1/13
(vr42c-sp) Agreement for the Selection of a Vocational Rehabilitation Counselor (Spanish) 1/13
(vr43) Request for Change of Vocational Rehabilitation Counselor 4/11
(vr44) Vocational Rehabilitation Plan 4/18
(us citizenship attestation) US Citizenship Attestation Form ND
(citizenship sp) US Citizenship Attestation Form (Spanish) ND
(vr44s) Supplemental Billing Request 6/15
Student Information and Instructions 4/18
Job Placement Information and Instructions 7/18
(vr44 sic) Supportive Services Student Information and Instructions 7/18
(vr44 sic-sp) Supportive Services Student Information and Instructions (Spanish) 4/14
(vr44 sid) Supportive Services Student Information and Instructions 4/14
(vr44 sid-sp) Supportive Services Student Information and Instructions (Spanish) 4/14
(2022 js mileage) Job Search Activity Log - Travel After 1/01/2022 1/22
(2021 js mileage) Job Search Activity Log - Travel after 1/01/2021 12/20
(2020 js mileage) Job Search Activity Log - Travel after 1/01/2020 2/20
(2019 js mileage) Job Search Activity Log - Travel after 01/01/2019 12/18
(2022 ged mileage) GED,ELL,ABE Training Mileage - Travel After 01/01/2022 1/22
(2021 ged mileage) GED,ELL,ABE Training Mileage - Travel After 01/01/2021 12/20
(2020 ged mileage) GED,ELL,ABE Training Mileage - Travel After 01/01/2020 1/20
(2019 ged mileage) GED,ELL,ABE Training Mileage - Travel After 01/01/2019 12/18
(2022 training mileage) Formal Training Mileage Reimbursement - Travel after 01/01/2022 1/22
(2021 training mileage) Formal Training Mileage Reimbursement - Travel after 01/01/2021 12/20
(2020 training mileage) Formal Training Mileage Reimbursement - Travel after 01/01/2020 1/20
(2019 training mileage) Formal Training Mileage Reimbursement - Travel after 01/01/2019 12/18
(monthly tutor payment) Monthly Tutor Payment Form 4/11
(progress report) Instructors Monthly Progress Report 4/11
(study program) Program of Study 4/11
(praecipe transcript) Praecipe for Transcript N/D
(notice appeal) Notice of Appeal N/D
(boe request) Request for Bill of Exceptions N/D
(affapp) Affidavit and Application to Proceed Without Payment of Costs N/D
(rtwsvc) Return to Work Services Information Sheet 7/20
(rtwsvc sp) Return to Work Services Information Sheet- Spanish 7/20

  • Rule 1 Office Of The Court

  • Rule 2 Filings

  • Rule 3 Pleadings

  • Rule 4 Discovery

  • Rule 5 Interpreters

  • Rule 6 Pretrial Conferences

  • Rule 7 Allotted Time For Trial

  • Rule 8 Continuances

  • Rule 9 Reporting Or Recording The Proceedings

  • Rule 10 Evidence

  • Rule 11 Decisions

  • Rule 12 Appearance, Withdrawal, and Substitution of Counsel

  • Rule 13 Fax Filings

  • Rule 14 Bill of Exceptions (Repealed effective January 21, 2016)

  • Rule 15 Records Checked Out

  • Rule 16 Briefs (Repealed effective January 21, 2016)

  • Rule 17 Scheduling, Argument, and Submission (Repealed effective January 21, 2016)

  • Rule 18 Summary Dispositions (Repealed effective January 21, 2016)

  • Rule 19 Opinions (Repealed effective January 21, 2016)

  • Rule 20 Dismissal of Appeal (Repealed effective January 21, 2016)

  • Rule 21 Costs (Repealed effective January 21, 2016)

  • Rule 22 Appeal After Review (Repealed effective August 31, 2011)

  • Rule 23 Dismissal Docket

  • Rule 24 Meetings Of The Court

  • Rule 25 Compliance With Rules

  • Rule 26 Schedules Of Fees For Medical, Surgical, And Hospital Services

  • Rule 27 Insurance and Self - Insurance (repealed)

  • Rule 28 Corporate Executive Officer Waiver (repealed)

  • Rule 29 First Report Of Alleged Occupational Injury Or Illness

  • Rule 30 Subsequent Report

  • Rule 31 Periodic Report of Continuing Compensation (Repealed)

  • Rule 32 Reporting Of Compensation Insurance

  • Rule 33 First Treatment Medical Reports

  • Rule 34 30-day Medical Report (repealed)

  • Rule 35 Blank Forms

  • Rule 36 Eligibility And Approval Of Vocational Rehabilitation Services

  • Rule 37 Vocational Rehabilitation Reporting

  • Rule 38 Vocational Rehabilitation Costs

  • Rule 39 Vocational Rehabilitation Certification Of Vocational Rehabilitation Service Providers

  • Rule 40 Vocational Rehabilitation Certification Of Counselors

  • Rule 41 Vocational Rehabilitation Certification Of Job Placement Specialists

  • Rule 42 Vocational Rehabilitation Choice Of Counselor

  • Rule 43 Vocational Rehabilitation Change Of Counselor

  • Rule 44 Vocational Rehabilitation Plan Development And Implementation

  • Rule 45 Loss Of Earning Power Evaluation

  • Rule 46 Settlement Agreements (repealed)

  • Rule 47 Lump Sum Settlement

  • Rule 48 Informal Dispute Resolution

  • Rule 49 Definitions

  • Rule 50 Choice Of Physician

  • Rule 51 Managed Care Purpose

  • Rule 52 Managed Care - Application For Certification

  • Rule 53 Managed Care - Requirements For Certification

  • Rule 54 Managed Care - Coverage

  • Rule 55 Managed Care - Notice To Employee

  • Rule 56 Managed Care - Physicians Who Are Not Participating Physicians

  • Rule 57 Managed Care - Reporting Requirements

  • Rule 58 Managed Care - Dispute Resolution

  • Rule 59 Managed Care - Peer Review And Utilization Review

  • Rule 60 Managed Care - Medical Case Management

  • Rule 61 Managed Care - Suspension; Revocation

  • Rule 62 Independent Medical Examiners - Appointment

  • Rule 63 Independent Medical Examiners Selection

  • Rule 64 Independent Medical Examiners - Procedures Before The Independent Medical Examiner

  • Rule 65 Independent Medical Examiners - Fees And Costs

  • Rule 66 Independent Medical Examiners - Removal

  • Rule 67 Independent Medical Examiners Selected By Agreement Of The Parties

  • Rule 68 Rules And Regulations

  • Rule 69 Insurance And Self Insurance

  • Rule 70 Self - insurance Purpose

  • Rule 71 Self - insurance Application For Approval

  • Rule 72 Self - insurance Requirements For Approval

  • Rule 73 Self - Insurance Security

  • Rule 74 Self - insurance Excess Insurance

  • Rule 75 Self - Insurance Reporting Requirements

  • Rule 76 Self - Insurance Renewal, Termination

  • Addendum 1 Present Value Table Nebraska Workers' Compensation Court

  • Addendum 2 U.S. Life Table : 2015 Expectancy Expressed in Years Nebraska Workers' Compensation Court

  • Addendum 3 In the Nebraska Workers' Compensation Court

    • Chapter 44 Insurance

    Chapter 48 Labor (48-101 - 48-1118)

    Misc. Related Statutes