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Workers Compensation for Alaska

  • Affidavit Of Compensation Rate Less Than $154 (form 07-6175)
    File .pdf (171.9 Kbytes)
  • Affidavit Of Readiness For Hearing (form 07-6107)
    File .pdf (133.1 Kbytes)
  • Application For Certificate Of Self-insurance (form 07-6129)
    File .pdf (20.1 Kbytes)
  • Carpal Tunnel Syndrome Questionare
    File .pdf (7.2 Kbytes)
  • Claim For Benefits (form 07-6106)
    File .pdf (24.9 Kbytes)
  • Compelling Reasons Questionnaire
    File .pdf (15.1 Kbytes)
  • Compensation Report (form 07-6104b)
    File .pdf (114.9 Kbytes)
  • Compromise & Release Agreement Summary (form 07-6117)
    File .pdf (173.8 Kbytes)
  • Controversion Notice (form 07-6105)
    File .pdf (23.7 Kbytes)
  • Death Benefits Report (form 07-6118)
    File .pdf (165.8 Kbytes)
  • Employers` Notice Of Insurance (form 07-6120)
    File .pdf (141 Kbytes)
  • Fisherman's & Physician's Reports
    File .pdf (30 Kbytes)
  • Instructions & Form For Executive Officer Waiver (form 07-6131)
    File .pdf (16.5 Kbytes)
  • Medical Summary (form 07-6103)
    File .pdf (10.6 Kbytes)
  • Notice Of Possible Claim Against The Second Injury Fund (form 07-6110)
    File .pdf (87.5 Kbytes)
  • Petition (form 07-6111)
    File .pdf (24.4 Kbytes)
  • Petition To Join Second Injury Fund & Claim For Reimbursement (form 07-6109)
    File .pdf (9.7 Kbytes)
  • Physician`s Report (form 07-6102)
    File .pdf (25.6 Kbytes)
  • Release Of Counseling, Psychological, Psychiatric, Or Alcohol/drug/substance Abuse Treatment Records Or Information
    File .pdf (6.2 Kbytes)
  • Release Of Medical Information
    File .pdf (6.1 Kbytes)
  • Renewing Status As A Self-insured Employer In Alaska (form 07-6130)
    File .pdf (16.1 Kbytes)
  • Report Of Occupational Injury Or Illness (form 07-6101)
    File .pdf (144.6 Kbytes)
  • Request For Conference (form 07-6135)
    File .pdf (13.7 Kbytes)
  • Request For Cross-examination (form 07-6174)
    File .pdf (131 Kbytes)
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