Chapter 69L-3 — Workers' Compensation Claims
27 rules · Division of Workers' Compensation· official chapter page
| 69L-3.001 | Purpose (Repealed) | 3/13/2013 |
| 69L-3.002 | Definitions | 6/30/2014 |
| 69L-3.003 | Procedures for Filing Documents | 6/30/2014 |
| 69L-3.0033 | Electronic Filing of Workers' Compensation Forms (Transferred) | 6/30/2014 |
| 69L-3.0035 | Injured Worker Informational Brochure | 6/30/2014 |
| 69L-3.0036 | Employer Informational Brochure | 6/30/2014 |
| 69L-3.004 | First Report of Injury or Illness: Employer's Responsibility to Record and Report Accidents (Transferred) | 6/30/2014 |
| 69L-3.0045 | First Report of Injury or Illness: Claim Administrator's Responsibility to Record and Report Accidents (Transferred) | 6/30/2014 |
| 69L-3.0046 | Wage Statement: Employer's and Claim Administrator's Responsibility to Record and Report Wages | 6/30/2014 |
| 69L-3.0047 | Fraud Statement | 6/30/2014 |
| 69L-3.009 | Injuries that Qualify as Grievous Bodily Harm of a Nature that Shocks the Conscience | 3/8/2023 |
| 69L-3.0091 | Notice of Action/Change (Transferred) | 6/30/2014 |
| 69L-3.012 | Notice of Denial (Transferred) | 6/30/2014 |
| 69L-3.016 | Claim Cost Report | 6/30/2014 |
| 69L-3.017 | Notice of Apportionment of Medical Reimbursement Due to a Pre-Existing Condition(s) | 6/30/2014 |
| 69L-3.018 | Wage Loss Benefits Due to Permanent Impairment (Dates of Accident August 1, 1979 through December 31, 1993) (Repealed) | 10/28/2015 |
| 69L-3.019 | Wage Loss Benefits for Temporary Partial Disability (Dates of Accident August 1, 1979 through December 31, 1993) (Repealed) | 10/28/2015 |
| 69L-3.0191 | Temporary Disability Benefits (Dates of Accident January 1, 1994 through September 30, 2003) (Repealed) | 10/28/2015 |
| 69L-3.01915 | Temporary Partial Disability Benefits (Dates of Accident on or After October 1, 2003) | 6/30/2014 |
| 69L-3.0192 | Impairment Income Benefits (Dates of Accident January 1, 1994 through September 30, 2003) (Repealed) | 10/28/2015 |
| 69L-3.01925 | Impairment Income Benefits (Dates of Accident on or After October 1, 2003) | 6/30/2014 |
| 69L-3.0193 | Supplemental Income Benefits (Dates of Accident January 1, 1994 through September 30, 2003) (Repealed) | 10/28/2015 |
| 69L-3.0194 | Permanent Total and Permanent Total Supplemental Benefits for Dates of Accident Prior to October 1, 2003 | 6/30/2014 |
| 69L-3.01945 | Permanent Total and Permanent Total Supplemental Benefits for Dates of Accident on or After October 1, 2003 | 6/30/2014 |
| 69L-3.021 | Additional Income Source Reports | 6/30/2014 |
| 69L-3.0213 | Aggregate Claims Administration Change Report (Repealed) | 7/1/2012 |
| 69L-3.025 | Forms | 6/30/2014 |