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Updated West Virginia Workers' Compensation Employee's and Physician's Report of Injury for Brickstreet (PDF)
Unusual Incident/Accident Report Form - Employee (PDF)
- 2022 - Incident report must be submitted to the Finance Office by the end of the
same day
on which the incident occurred
Unusual Incident/Accident Report Form - Employee -
Fillable Online
(PDF)
Election of Option Form for Workers' Compensation (DOC)
- Must be completed within 3 days of a job related injury causing absence.
West Virginia - Offices of the Insurance Commissioner - Workers' Compensation
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