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Workers' Compensation Division Forms

The forms listed below are the official New Hampshire State Forms. Your insurance carrier is responsible for supplying the Workers' Compensation forms. Most of the forms are discussed in detail in the Employer's Guide to Workers' Compensation Adobe Acrobat Reader Symbol.

Claims | Self Insurance | Second Injury Fund | Third Party Administrators | Job Modification | Vocational Rehabilitation

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back to topSelf Insurance

back to topSecond Injury Fund

back to topThird Party Administrators

back to topJob Modification

back to topVocational Rehabilitation

These are the formats a CVRP is required to follow when submitting these required documents to the New Hampshire Department of Labor. Please refer to New Hampshire Administrative Rules Chapter LAB 509 Vocational Rehabilitation and Chapter LAB 516 Certification of Vocational Rehabilitation Providers for further directions.

Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.


New Hampshire Department of Labor  |  
95 Pleasant Street  |  Concord, NH 03301
Telephone: 603-271-3176  |  
Hours of Operation: 8am - 4:30pm M-F