Employer Toolkit - Virginia
Your resource for State Specific Forms and Regulatory Links
Visit our Employer FAQ page for answers to employer related questions.
State Forms
First Report of Injury [VWC Form #3]
Initial Treatment Authorization
New Policyholder Welcome Packet - VA
No Treatment Requested Letter
No Treatment Requested Letter - Creole
No Treatment Requested Letter - Spanish
Pharmacy Authorization - VA
VA Application for Drug-Free Workplace Premium Credit
Wage Chart [VWC Form No. 7A]
Workers' Compensation Notice - VA
Workers' Compensation Notice - VA - Spanish
Claim Forms
First Report of Injury [VWC Form #3]
Initial Treatment Authorization
New Policyholder Welcome Packet - VA
No Treatment Requested Letter
No Treatment Requested Letter - Creole
No Treatment Requested Letter - Spanish
Pharmacy Authorization - VA
VA Application for Drug-Free Workplace Premium Credit
Wage Chart [VWC Form No. 7A]
Workers' Compensation Notice - VA
Workers' Compensation Notice - VA - Spanish
Links
Virginia Workers’ Compensation Commission
Rejection of Coverage Waiver Form 16A
Revocation of Prior Rejection Form 17A