vwc
VWC
Commission Home Page |Email Us! |The Commission's Web Policy
Forms
Self Insurance
Workers' Compensation
Empl Insur Monitoring
Publications















Forms
You can get many of the forms you need directly from this page. Click on the desired form to display it on-line. It may be printed from your browser. (In Netscape and Internet Explorer, select "File, Print" from the menu.)

Accidents that occur on or after 10/1/08 are reported to VWC electronically via EDI. There is a phased approach to EDI. For more information about EDI, click here

If you are not yet reporting post 10/1/08 accidents via EDI, continue to use paper reports. You are free to use a “old” EAR form to report the accident, or you may use a new FROI. These forms may be found here

Note that VWC no longer allows the non-minor accident reports, formerly known as EAR, to be reported via the internet. Use the paper version described above and mail to the Commission. The time limits for these filings has not changed. You are not required to use colored paper.

Minor accidents, reported on Form 45A, may be reported via the internet at http://www.vwc.state.va.us/e_filing.htm. Note that this is for non-EDI filers only. If your organization reports via EDI, then you will report minor accidents via EDI.

Some of these forms must be submitted on paper of a specific color. Where a specific color is required, the Commission will not accept a form printed on different color paper. The required paper color is given to the right of the name of each form. The paper specified is Hammermill paper.

Workers' Compensation Forms for Pre 10/1/08 Accidents
(claim forms and other forms used in the workers' compensation process)

 Workers’ Compensation Forms for Post-10/1/08 Accidents


*Note:  If you use the older version of this form, you will need to have it notarized since it does contain the necessary perjury language

Subpoena Forms

Employers' Insurance Monitoring Forms

Self-Insurance Forms

Taxation Forms

Petition Under Virginia Birth-Related Neurological Injury Act