Colorado Workers Compensation Forms. Forms should be typed or printed legibly. The employer has the right in the first instance to select the physician who attends the injured employee.
This form should be completed by the employee. Free download colorado workers compensation information form pdf 383kb and customize with our editable templates waivers and forms for your needs. All questions must be answered completely to meet requirements of the colorado workers compensation act and to conform to the osha requirements for form no.
The standard acord 130 application form for workers comp coverage in colorado.
The most secure digital platform to get legally binding electronically signed documents in just a few seconds. This form is used by employers to obtain certification status in the colorado workers compensation premium cost containment program. By signing this form you are acknowledging that you are responsible to pay all federal state and local taxes and are responsible and liable for all work related injures. If a party disagrees with an authorized treating physician s impairment rating and or the date of mmi you have the right to request a dime.
