Get the free VIRGINIA Workers Compensation Key Forms &amp; Dates

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First Report of Injury Virginia Workers Compensation Commission 1000 DMV Drive Richmond Virginia 23220 18776642566Reason for filing: VOC Jurisdiction Claim #: (If assigned)SEE INSTRUCTIONS ON REVERSE

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How to fill out virginia workers compensation key

01

Begin by acquiring the Virginia workers compensation key form from the official website or your employer.

02

Read the instructions carefully to understand the purpose and requirements of the form.

03

Provide your personal information such as your name, address, date of birth, and contact details in the designated sections.

04

Enter your employer's information, including their name, address, and contact details.

05

Specify the date and time of the incident or injury for which you are filing the workers compensation claim.

06

Describe the details of the incident or injury, including how it occurred, any witnesses present, and any immediate actions taken.

07

Include information about any medical treatment received, the healthcare provider's name, address, and contact details.

08

Attach any relevant medical records, bills, or other supporting documents to substantiate your claim.

09

Sign and date the Virginia workers compensation key form to certify the accuracy and truthfulness of the provided information.

10

Submit the completed form to the appropriate authority as instructed.

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Keep a copy of the filled out form for your records.

12

Follow up with the concerned authority to track the progress of your workers compensation claim.

Who needs virginia workers compensation key?

01

Employees who sustain work-related injuries or illnesses in Virginia and seek compensation for medical expenses, lost wages, and other related benefits need the Virginia workers compensation key.

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