Here is an impairment rating template compatible with the state’s rule set

Impairment Rating Template for State Specific Rule Set (Word file)

Administrative Rule Set

None Specified

Labor Department

Here is a link to the Workers’ Compensation Agency

Employer’s First Report of Injury

Here is a link to the Employee’s Report of Claim

Request for Authorization

Here is a link to Application for Reimbursement from the Medical Benefits Fund