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Workers Compensation for South Dakota

  • Calculation Of Compensation (form 110)
    File .pdf (5.2 Kbytes)
  • First Report Of Injury
    File .pdf (7.4 Kbytes)
  • General Instructions For First Report Of Injury
    File .pdf (6.8 Kbytes)
  • Independent Contractor Verification Application
    File .pdf (8 Kbytes)
  • Managed Care Compliance Certification
    File .pdf (4.7 Kbytes)
  • Managed Care Plan Certification Application
    File .pdf (42.8 Kbytes)
  • Mediation Request
    File .pdf (45.7 Kbytes)
  • Memorandum Of Payment For Permanent Partial Disability (form 111)
    File .pdf (5.1 Kbytes)
  • Memorandum Of Payment For Rehabilitation (form 113)
    File .pdf (5.1 Kbytes)
  • Monthly Payment Report (form 107)
    File .pdf (5.8 Kbytes)
  • Petition For Decertification
    File .pdf (38.2 Kbytes)
  • Petition For Election
    File .pdf (62.3 Kbytes)
  • Petition For Hearing
    File .pdf (57.1 Kbytes)
  • Petition For Hearing On Grievance
    File .pdf (60.1 Kbytes)
  • Petition For Unfair Labor Practice
    File .pdf (60.4 Kbytes)
  • Request For Conciliation
    File .pdf (64.2 Kbytes)
  • Request For Extension Of Time
    File .pdf (5.1 Kbytes)
  • Request For Fact Finding
    File .pdf (62.3 Kbytes)
  • Unit Determination
    File .pdf (38.2 Kbytes)
  • Wage Complaint Form
    File .pdf (59.6 Kbytes)
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