the gateway for staffing
companies to report
work comp claims
Forms and other Resources
Note on PDF files:
Most of our PDF forms are fillable. Simply right click on the link and choose either "save as" OR "download file." You can then open the PDF file (in any PDF Reader program,) fill in the highlighted fields, save, print, and/or email the file.
Functional Job Description (online form)
The functional job description is one of the best tools for identifying the discrete and unique physical requirements associated with a position. The primary goal is returning the employee to the workforce.
FJD (Functional Job Description) Online Form
Employee Refusal of Medical Treatment Form
Employee Refusal of Medical Treatment Form (Fillable .pdf form)
Employee Release of Information Form
Employee Release of Information Form (Fillable .pdf form)
This form allows the release of information to have claims paid, approval for treatments, the filling of prescriptions, etc.
Medical Provider Links
Coventry Network Medical Providers (Click to open in a new window:)
Federal and State Labor Posters
Federal and State Labor Posters (Click to open list of states:)