Workers' Compensation Claims Kits

Effective and efficient claims management is the best way CopperPoint Insurance Companies can bring you peace of mind. These resources provide you with valuable information regarding CopperPoint’s Claims Division and the tools we use to make sure that appropriate and timely benefits are paid.

Employer Report of Industrial Injury Form (101)

CopperPoint Subrogation - MC1011.pdf

Reporting a Workplace Injury - MC1006.pdf

Return-to-Work Program - MC1005.pdf

How CopperPoint Controls Medical Costs - MC021.pdf

Workers Compensation Benefits - MC041.pdf

CopperPoint Claims Management - MC1003.pdf

Filing a Claim Online.pdf

12 Steps to Lowering Your Workers Comp - MC1004.pdf

Sample Return to Work Forms for Employers-LC601.pdf

ScriptAdvisor Workers' Comp First Fill Prescription Card

 

State Specific Poster and Claims Forms


Colorado

https://www.colorado.gov/pacific/sites/default/files/WC049_Work_Comp_Poster.pdf

https://www.colorado.gov/pacific/sites/default/files/WC049s_Work_Comp_Poster_Spanish.pdf

https://www.colorado.gov/pacific/sites/default/files/WC050_Notice_of_Injury_Poster.pdf

https://www.colorado.gov/pacific/cdle/forms-3


New Mexico

https://workerscomp.nm.gov/sites/default/files/documents/publications/poster11x17.pdf

https://workerscomp.nm.gov/sites/default/files/documents/publications/noa.pdf

https://workerscomp.nm.gov/sites/default/files/documents/publications/fraud_poster.pdf (This FRAUD poster is not required)

https://workerscomp.nm.gov/NMWCA-Forms


Nevada

http://dir.nv.gov/uploadedFiles/dirnvgov/content/WCS/EmployersDocs/MandatoryPostingRequirements.pdf

http://dir.nv.gov/uploadedFiles/dirnvgov/content/WCS/EmployersDocs/d-1.pdf

http://dir.nv.gov/uploadedFiles/dirnvgov/content/WCS/d-22.pdf

http://dir.nv.gov/WCS/Workers__Compensation_Forms_and_Worksheets/


Utah

https://laborcommission.utah.gov/media/pdfs/industrialaccidents/pubs/poster-english.pdf

https://laborcommission.utah.gov/divisions/IndustrialAccidents/WorkersComp/wcclaimforms.html