Injury Management Resources

Limited HIPAA Release
Clinic Evaluation
Acknowledgement of Refusal of Coverage
Claims Red Flag Check List
Request for WC Medical Information
Infographic: Remembering Workers - Workers Memorial Day 2014
Medical Clinic Evaluation Form
"Actively at Work" Map
HIPAA and Workers' Comp - A Report from the Office of Civil Rights
Declaration of No Injury
OSHA 300 Form
List of Business Types that Are Not Required to Post OSHA 300A Forms
Carrier Code List
What to do when OSHA Knocks
Certification of Health Care Provider for Employee's Serious Health Condition (FMLA)
FMLA Designation Notice
FMLA Notice of Eligibility and Rights & Responsibilities
North Carolina FMLA/WorkComp Law Summary
Accident Investigation Form
Witness Statement Form
Back on the Job Manual
Claims Management Review Checklist
Claims Review Checklis
Early Return to Work Checklist
Loss Cost Review and Loss Stratification Checklists
Loss Trend Checklist
Loss Trend Review Checklist
Safety Plan IIP Checklist
Safety Plan Review Checklist
Pre-Injury Map
Post-Injury Map
Recovery at Work Coordinator