OAC

Forms - Workers Compensation

Hearings:


 Instructions for completing an Application or Response    español 

Application for Hearing and Notice to Set    PDF     Word   Modified 12/19/07

Application for Expedited Hearing     PDF     Word     Modified 12/26/07

Application for Expedited Hearing One Time Change     PDF     Word     03/05/08

Application for Hearing, Disfigurement Only    PDF     Word     Modified 04/03/08

Case Information Sheet (CIS)   PDF     Word      Modified 12/26/07

 Code of Conduct for Interpreters     

Entry of Appearance    PDF     Word        05/05/06

Hearing Confirmation Form     PDF     Word          Modified 05/05/06

 Hearing Cancellation Form    (fill-able PDF) 05/05/06

Response to Application for Hearing    PDF     Word          Modified 7/20/11

Request for Specific Findings of Fact and Conclusions of Law   PDF     Word             Modified 12/19/07

 Subpoena Form 

 

Review Process


 Request a Copy/Transcript of a Hearing (fill-able PDF) Modified 10/18/05

Petition to Review in Workers' Compensation    PDF       Word    Revised 05/05/06

Petition to Review & Transcript Request in Workers' Compensation   PDF       Word      Revised 05/05/06

 

Other Worker's Comp Forms


Photo Disfigurement  - Workers' Compensation     PDF       Word          Modified 04/03/08