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

has a state specific rule set. Please see the link to the labor department below for more information.

Physician’s Report

Physician’s Initial Report of Work Injury or Occupational Disease

Here is a link to Physician’s Initial Report

Permanent Partial Disability Worksheet

Here is a link to Permanent Partial Disability Worksheet

Labor Department

Here is a link to Industrial Accidents Division

Employer’s First Report of Injury

Here is a link to First Report of Injury

Request for Authorization

Here is a link to Request for Medical Treatment/Carrier Response (Form 223)