How Were Different: Claims Forms
Claims Forms
Below are the links to Workers' Compensation Claims Forms
Friedlander Group Client Portal offering secure 24/7 online claims reporting and reports
Workers’ Compensation C-2 Claim Form
- Employers Report of a Work Related Injury or Illness. If one of your employees has a work-related injury or illness, you should complete and submit this form to Friedlander Group, or file the claim directly through your Client Portal
- Employers Report of Injured Employee's Change in Employment Status Resulting from Injury. Change in employment status includes return to work, discontinuance of work, increase or decrease of regular hours of work and increase or reduction of wages
- Employer's Statement of Wage Earnings for 52 Weeks
- Employers Request for Reimbursement
- Information to provide employees when they have a workers' compensation claim
Claimant Information Packet in Spanish
Información para proporcionar a los empleados cuando tienen un reclamo de compensación para trabajadores
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