Mission Statement
The Workers’ Compensation Commission (WCC) program provides financial protection for both employers and employees from the catastrophic effects of work related injuries, death, disability and medical expenses including rehabilitation.
Compliance New/Renewal
- Certificate of Compliance, Form WCC-100 (1 page) (For Employers’ Insurance coverage)
Injury Claim Forms
- Claim Forms (10 Pages)
- Notice of First Payment, Suspension or Final Payment, Form WCC-209 (1 Page)
- Notice by Employer to Controvert, Form WCC-206 (1 Page)
- Application for Lump Sum Award, Form WCC-208 (1 Page)
Self-Insurance
Business License Clearance
- Application for Certificate of Clearance, Form WCC-101 (1 Page)
- Application for Business License (DOF Rev. & Tax. Business License Section)
Carriers SDF Quarterly Remittance
Hearing
