Updated West Virginia Workers' Compensation Employee's and Physician's Report of Injury for Brickstreet

Unusual Incident/Accident Report Form - Employee (PDF version) - NEW - July  2017
(An incident report must be submitted to the Finance Office by the end of the SAME DAY on which the incident occurred.)

Election of Option Form for Workers' Comp - must be completed within 3 days of a job related injury causing absence.

West Virginia - Offices of the Insurance Commissioner - Workers' Compensation