Form 32 Workcover
Mauricette Atencio
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Submit forms online through the Employees' Compensation Operations and Management Portal (ECOMP). On the ECOMP site you can register for an account, initiate a claim, upload documents, submit forms, and access your case.
OWCP's Federal Employees Program has made a variety of forms available online. These forms are only available in PDF format. In order to view and/or print PDF documents you must have a PDF viewer. It is highly recommended that you have the most current version (click on Adobe Acrobat Reader to download the current version) available on your workstation. These forms can be viewed in an Internet Explorer browser window, but not in other browsers. If you are using Chrome or Firefox, follow these instructions to download PDF files and open them in Adobe Acrobat Reader.
All of the Federal Employees Program's online forms (with the exception of Forms CA-16, CA-26 and CA-27) are available to print and to manually fill and submit. Simply click on the appropriate form and print it using the [Print] button provided near the top of the form. Write or type the required information on the hardcopy and authorize the form, if applicable, with a hand-written signature. Then mail or fax the completed form to the Federal Employees Program office you normally send to for this process.
Forms noted with an asterisk (*) may be electronically filled. Simply click on the appropriate form, fill out the form using your computer keyboard and the key or your mouse to navigate between form fields. Print the form (use the Print button on or near the top of the form), authorize the form (if applicable provide hand-written signature) and mail or fax the completed form to the Federal Employees Program office you normally send to for this process.
NOTE: When printing these files please remember to use the Adobe Acrobat Reader print icon or the [Print] button on the form, itself, and NOT your browser's print icon on the browser toolbar.
This form is only available to registered medical providers by logging into the OWCP Web Bill Portal. To submit the form, providers must click on the 'Provider' Link to the right of the FECA oval located at the top left of the home page, login with their user ID and password, and then click on the 'LMN Documents' link located in the left menu bar. For providers not yet registered, after clicking the 'Provider' link, click the 'Web Registration' link located in the left menu bar to register for web access. For providers not yet enrolled, click on 'Forms & Links' in the horizontal menu at the top of the home page to download the Provider Enrollment form and instructions.
Workers Compensation Claim Form
The claim form includes information on the claims process and your rights, responsibilities and entitlements when making a claim for workers compensation.
WorkCover WA provides an online lodgement facility for submitting applications for conciliation. An electronic version of the Application for Conciliation for use by unrepresented workers or uninsured employers, or when the online system is unavailable, is below.
Complete and lodge this form with the Application for Conciliation when applying for; additional income compensation; or a standard increase in the medical and health expenses general limit amount; or an increase for special expenses in the medical and health expenses general limit amount.
Workers Compensation and Injury Management Conciliation Rules 2024
The Conciliation Rules support the arrangements for resolving workers compensation disputes in Western Australia. All parties to a dispute need to comply with the Conciliation Rules.
WorkCover WA provides an online lodgement facility for submitting applications for arbitration. An electronically writeable and printable version of the appropriate application form for use by unrepresented workers, unrepresented dependants or uninsured employers, or when the online system is unavailable, is below.
Complete this form and lodge with the Application for Arbitration when applying for additional income compensation or a standard increase in the medical and health expenses general limit amount and/or an increase for special expenses in the medical and health expenses general limit amount.
Workers Compensation and Injury Management Arbitration Rules 2024
The Arbitration Rules support the arrangements for resolving workers compensation disputes in Western Australia. All parties to a dispute need to comply with the Arbitration Rules.
WorkCover WA acknowledges the traditional custodians throughout Western Australia and their continuingconnection to the land, waters and community. We pay our respects to all members of the Aboriginalcommunities and their cultures; and to Elders both past and present.
Request for Adjournment / Ready Hold - additional page
** Open form and enter in your firm name and contact info. Save the form onto your computer by hitting Save As. Use the saved form as a template for future Adjournment Requests. This form can now be e-mailed to the individual district offices. Follow instructions on the form.
COURTS on-line Internet Access Application (fillable): this application package needs to be completed if a law firm, insurance carrier or self-insured is interested in accessing COURTS on-line, the Division's on-line case management website. Package contains both the Designation of Contact form and Subscriber application form.
COURTS on-line Subscriber Change Form (fillable): this form needs to be completed if an existing COURTS on-line subscriber has had a change to their name or e-mail address or if their e-filing access level request has changed. The form must be signed by the firm's Contact Person prior to submitting.
Report of Non-Compliance (online): this form may be used by any individual or organization to report allegations of failure on the part of an employer to maintain workers' compensation insurance coverage or obtaining authorization to self-insure.
Insurance Carrier / Self-Insurer Contact Listing: these individuals can be contacted by judicial staff and attorneys where there has been no appearance or formal response made by the carrier or their counsel on pending Motions for Medical and Temporary Benefits.
Due to planned OnBoard maintenance occurring between 2:00 a.m. to 5:00 a.m. ET on Monday, July 22, 2024, and between 2:00 a.m. to 2:30 a.m. ET on Tuesday, July 23, 2024, email and text notifications may not be generated during this period. Please check your dashboards for prior authorization requests (PARs) and PAR responses submitted during this period. All other functionality will be working, including updates to the electronic case folders in eCase.
During the COVID-19 pandemic, individuals seeking to serve legal papers on the Board should file their papers by mail with the Office of the Secretary at 328 State Street, Schenectady, NY 12305. See the Personal Service Upon the Board notice for more information.
Related questions regarding business licensing and filing requirements as set forth in Code of Virginia 58.1-3714 should be directed to the Commissioner of the Revenue office for the locality from which the business license is sought. See Commissioners of the Revenue Association of Virginia for complete contact information.
Contractors: Effective immediately, Form 61A - Certificate of Workers' Compensation Insurance online filing tool has been eliminated. Code of Virginia 65.2-800 and 58.1-3714 requires that signed certifications of insurance coverage from contractors are to be provided by the localities, not by the contractor. Specific questions regarding the necessity of the form to obtain/renew a business license should be directed to the Commissioners of the Revenue Association of Virginia.
Code of Virginia 58.1-3714 (B)(2) requires insurance coverage certification from contractors only rather than from all employers seeking a business license. It is not necessary for all businesses, but only contractors, to certify insurance coverage.
Virginia requires Virginia coverage for work performed in Virginia, even temporary work. Virginia does not have reciprocity with any other states. Most employers with coverage based out of state can obtain proper Virginia coverage with the addition of a Virginia endorsement on the existing policy adding Virginia to item 3A of the policy. Virginia listing under item 3C of the policy is not sufficient.
The workers' compensation community is encouraged to eliminate paper and mailing delays, while adding additional hours to the workday through filing paperwork and managing claims online through WCAIS.
Welcome to the department's Workers' Compensation LIBC Forms. The form hyperlinks are designed to provide a resource, but not supersede any statuary or regulatory requirements relating to form filing. When a copy of a form is required by law, to be provided to another party, a true and correct copy of such information must be provided to that party consistent with the act, regulations and/or any applicable department-issued policy statement or written guidance.