All 50 States’ and D.C.’s Home Pages
and Workers’ Compensation Agencies
The International Association of Industrial
Accident Boards and Commissions and the
U.S. Department of Labor also
maintain excellent detailed lists of workers’ compensation agencies. Click here
to view the directory of
State Workers’
Compensation Officials, compiled by the
Division of Federal Employees’
Compensation of the U.S. Department of Labor’s
Office of Workers’ Compensation Programs
(OWCP). Click here to view a list of
State Workers’ Compensation Laws, compiled by the OWCP.
The N.C. Industrial Commission’s list of U.S. workers’ compensation agencies
is a separate document. It is updated daily, as we receive new information; and
is probably the most complete and up-to-date listing of its type available
anywhere. Click here for a comprehensive Workers’ Compensation
Administrators Directory for the United States and Canada (http://www.ic.nc.gov/ncic/pages/wcadmdir.htm).
Note: The following list may be reprinted for free as long as it
contains this credit line: “This Workers’ Compensation
Administrators Directory was compiled by Robert W. McDowell for the North
Carolina Industrial Commission, 4340 Mail Service Center, Raleigh, North
Carolina 27699-4340.”
Robert W. McDowell
Webmaster
N.C. Industrial Commission
This list was last updated on 10 January 2011. Please e-mail any comments and
corrections to:
Robert.McDowell@ic.nc.gov.
TABLE OF CONTENTS FOR THIS PAGE
United States and D.C.:
U.S. Department of Labor
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other U.S. Areas: American Samoa
Guam
Navajo Nation
Northern Mariana Islands
Puerto Rico
Virgin Islands
United States and D.C.
U.S. Department of Labor
U.S. Department of Labor (DOL)http://www.dol.gov/
200 Constitution Avenue NW
Washington, District of Columbia 20210
(202) 693-6000
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Alabama
State of Alabamahttp://www.al.gov/
Department of Industrial Relationshttp://dir.alabama.gov/
Workers’ Compensation Divisionhttp://dir.alabama.gov/wc/
Industrial Relations Building
649 Monroe Street
Montgomery, Alabama 36131
(800) 528-5166, (334) 242-2868; Fax: (334) 353-8262 (Administrative/TPAs/Assessments/Self-Insurance),
(334) 353-8228 (Examiners/Ombudsman), (334) 353-0840 (Claims), (334) 353-8490 (Compliance/Drug Free/Medical/Education); Fraud: (800)
923-2533; Ombudsman: (800) 528-5166, (334) 242-2868 (in Montgomery area)
Return to top of page
Alaska
State of Alaskahttp://www.state.ak.us/
Department of Labor and
Workforce Developmenthttp://www.labor.state.ak.us/home.htm
Workers’ Compensation Divisionhttp://www.labor.state.ak.us/wc/wc.htm
Post Office Box 25512
Juneau, Alaska 99802-5512
(907) 465-2790; Fax: (907) 465-2797
Workers’
Compensation Boardhttp://www.gov.state.ak.us/boards/factsheet/fact110.html
Department of Labor
Post Office Box 25512
M/S 0700
Juneau, Alaska 99802-5512
(907) 465-2790, Fax: (907) 465-2797
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Arizona
State of Arizonahttp://www.state.az.us/
Industrial Commission of Arizonahttp://www.ica.state.az.us/
800 West Washington
Phoenix, Arizona 85007
or
Post Office Box 19070
Phoenix, Arizona 85005-9070
(602) 542-4411, Fax: (602) 542-7889; Ombudsman: (602) 542-4538, Fax: (602)
542-4350
Click here to download free fillable PDF (Portable Document
Format) versions of Arizona workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Industrial Commission Review Board
State Compensation Fund (SCF Arizona)http://www.scfaz.com/
3031 North Second Street
Phoenix, Arizona 85012
(602) 631-2000; Fax: (602) 631-2213
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Arkansas
State of Arkansashttp://www.state.ar.us/
Workers’ Compensation Commissionhttp://www.awcc.state.ar.us/
Street Address:
324 Spring Street
Little Rock, Arkansas 72203
Mailing Address:
Post Office
Box 950
Little Rock, Arkansas 72203-0950
(800) 622-4472, (501) 682-3930; Fax: (501) 682-2777; Legal Advisor
Direct: (800) 250-2511; TDD: (800) 285-1131
Arkansas Relay System TDD: (800) 285-1131
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California
State of Californiahttp://www.ca.gov/
Department of
Industrial Relationshttp://www.dir.ca.gov/
Commission on Health and Safety
and Workers’ Compensation (CHSWC)http://www.dir.ca.gov/chswc/chswc.html
1515 Clay Street, Room 901
Oakland, California 94612
(510) 622-3959, Fax: (510) 622-3265
E-mail: chswc@hq.dir.ca.gov
Division of Workers’
Compensation (DWC)http://www.dir.ca.gov/dwc/dwc_home_page.htm
Street Address:
1515 Clay Street, 17th Floor
Oakland, California 94612
Mailing Address:
Post Office Box 420603
San Francisco,
California 94142
(800) 736-7401, (510) 286-7100
E-mail: dwc@dir.ca.gov
Click here to download free fillable PDF (Portable Document
Format) versions of California workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Division
of Workers’ Compensation Medical Unithttp://www.dir.ca.gov/dwc/MedicalUnit/imchp.html
Street Address:
1515 Clay Street, 18th Floor
Oakland, California 94612
Mailing Address:
Post Office Box 71010
San Francisco,
California 94142
(800) 794-6900 (in
California), (510) 286-3700, Complaint Line: (800) 999-1041
Workers’ Compensation Appeals
Board (WCAB)http://www.dir.ca.gov/WCAB/
Street
Address:
455 Golden
Gate Avenue, Suite 9328
San Francisco, California 94102-3660
Mailing Address:
Post Office Box 429459
San Francisco,
California 94142-9459
Information and Assistance Division: (800)
736-7401, (415) 703-5020
Self-Insurance Plans (SIP)http://www.dir.ca.gov/SIP/
2265 Watt Avenue, Suite 1
Sacramento, California 95825
(916) 483-3392, Fax: (916) 483-1535
E-mail: SIP@dir.ca.gov
State Compensation Insurance Fund (SCIF)http://www.scif.com/
1275 Market Street
San Francisco,
California 94103
(415) 565-1234, Claims Reporting Service (toll
free): (888) 222-3211, Fraud Hotline: (888) 786-7372
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Colorado
State of Coloradohttp://www.colorado.gov/
Department of Labor &
Employmenthttp://www.coworkforce.com/
633 17th Street, Suite 200
Denver, Colorado 80202-3660
Division of Workers’ Compensationhttp://www.coworkforce.com/dwc/
633 17th Street, Suite 400
Denver, Colorado 80202-3660
(888) 390-7936 (English), (800) 685-0891 (Spanish), (303)
318-8700, Fax:
(303) 318-8710, E-mail: workers.comp@state.co.us
Click here to download free fillable PDF (Portable Document
Format) versions of Colorado workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Industrial Claims Appeals Office
(ICAP)http://www.coworkforce.com/icao/
633 17th Street, Suite 600
Denver, Colorado 80202-3660
(303) 318-8131, Fax: (303) 318-8139
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Connecticut
State of Connecticuthttp://www.ct.gov/
Workers’ Compensation Commissionhttp://wcc.state.ct.us/
Capitol Place
21 Oak Street, Fourth Floor
Hartford, Connecticut 06106
(800) 223-9675 (toll-free in Connecticut), (860) 493-1500, Fax: (860) 247-1361
wcc.chairmansoffice@po.state.ct.us
Click here to download free fillable PDF (Portable Document
Format) versions of Connecticut workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Compensation Review Board (CRB)http://wcc.state.ct.us/wcc/crb.htm
Capitol Place
21 Oak Street, Fourth Floor
Hartford, Connecticut 06106
(203) 493-1500, Fax: (203) 247-1361
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Delaware
State of Delawarehttp://delaware.gov/
Department of Laborhttp://www.delawareworks.com/
4425 North Market Street
Wilmington, Delaware 19802
dlabor@state.de.us
Division of
Industrial Affairshttp://www.delawareworks.com/industrialaffairs/
4425 North Market Street, Third Floor
Wilmington, Delaware 19802
(302) 761-8200 (New Castle), (302) 422-1134 (Kent and Sussex)
Office of Workers’ Compensationhttp://www.delawareworks.com/industrialaffairs/services/WorkersComp.shtml
Street Address:
Fox Valley Office
4425 North Market Street
Wilmington, Delaware 19802
Mailing Address:
Post Office Box 9954
Wilmington, Delaware 19802-9954
(302) 761-8200 (New Castle), (302) 422-1134 (Kent
and Sussex), Fax:
(302) 761-6601
District of Columbia
District of Columbiahttp://www.dc.gov/
Department of Employment Serviceshttp://www.does.dc.gov/does/site/default.asp
Government of the District of Columbia
64 New York Avenue, N.E.
Washington, District of Columbia 20002
(202) 724-7000, Fax: (202) 724-5683, TDD/TYY: (202) 673-6994
E-mail: does@dc.gov
Labor Standards Bureau
64 New York Avenue, N.E., Room 3129
Washington, District of Columbia 20002
(202) 671-1555, Fax: (202) 673-6412
Office of Workers’ Compensationhttp://www.does.dc.gov/does/cwp/view.asp?a=1232&Q=537428
Mailing Address:
Post Office Box 56098
Washington, District of Columbia 20002
Street Address:
64 New York Avenue, N.E., Room 2909
Washington, District of Columbia 20002
(202) 671-1000, Fax: (202) 671-1929
Office
of Hearings and Adjudicationhttp://www.does.dc.gov/does/cwp/view.asp?a=1232&Q=537904
64 New York Avenue, N.E., Room 2011
Washington, District of Columbia 20002
(202) 671-2233, Fax: (202) 673-6938
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Florida
State of Floridahttp://www.myflorida.com/
Florida Department of Financial Serviceshttp://www.myfloridacfo.com/
200 East Gaines Street
Tallahassee, FL 32399-0300
(850) 413-3100, Consumer Helpline: (800) 342-2762
Division of Workers’ Compensationhttp://www.myfloridacfo.com/WC/
200 East Gaines Street
Tallahassee, Florida 32399-4220
(850) 413-1609; Fax: (850) 922-6779;
Injured Worker Helpline: (800) 742-2214; Fraud: (800) 742-2214 (in Florida) (Department of Insurance, Bureau of Workers’ Compensation Fraud:
(850) 413-3116); Safety: (800) 367-4378 (in Florida), (850) 488-3044
E-mail:
Workers.CompService@MyFloridaCFO.com
Click here to download free fillable PDF (Portable Document
Format) versions of Florida workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Florida Division of Administrative Hearingshttp://www.doah.state.fl.us/internet/
The Desoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32301-3060
(850) 488-9675; Fax: (850) 921-6847
Office of Judges of
Compensation Claimshttp://www.jcc.state.fl.us/jcc/
Petition for Benefits:
Post Office Box 8000
Tallahassee, Florida 32314-8000
Filing:
Post Office Box 8000
Tallahassee, Florida 32314-8000
Request for Assignment of Case Number:
Post Office Box 8000
Tallahassee, Florida 32314-8000
(850) 487-1911, SUNCOM 277-1911
Florida Department of Educationhttp://www.fldoe.org/
Florida Division of Vocational
Rehabilitationhttp://www.rehabworks.org/
2002 Old Saint
Augustine Road, Building A
Tallahassee, Florida 32301-4862
(800) 451-4327 (Voice/TDD), (850) 245-3399
(Voice/TDD)
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Georgia
State of Georgiahttp://www.georgia.gov/
Georgia
State Board of Workers’ Compensationhttp://sbwc.georgia.gov/
270 Peachtree Street, NW
Atlanta, Georgia 30303-1299
(800)
533-0682, (404)
656-3875, Fax: (404) 656-7768, Enforcement Division: (404)
657-1391, Safety Library: (404) 656-9057
Click here to download free fillable PDF (Portable Document
Format) versions of Georgia workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Georgia Subsequent Injury Trust Fundhttp://sitf.georgia.gov/
Suite 500, North Tower
1720 Peachtree Street, NW
Atlanta, Georgia 30309-2420
(404) 206-6360, Fax: (404) 206-6363, TDD: (404) 206-5053
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Hawaii
State of Hawaiihttp://www.hawaii.gov/portal/
Department of Labor & Industrial Relations
(DLIR)http://hawaii.gov/labor/
830 Punchbowl Street
Honolulu, Hawaii 96813
(808) 586-8842, Fax: (808) 586-9099, dlir.director@hawaii.gov
Disability Compensation Divisionhttp://hawaii.gov/labor/dcd/index.shtml
830 Punchbowl Street, #211
Honolulu, Hawaii 96813
(808) 586-9151, Fax: (808) 586-9219, dlir.workcomp@hawaii.gov
Labor & Industrial Relations Appeals Boardhttp://hawaii.gov/labor/hlirab/index.shtml
830 Punchbowl Street #404
Honolulu, Hawaii 96813
(808) 586-8600,
Fax: (808) 586-8599, dlir.laborboard@hawaii.gov
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Idaho
State of Idahohttp://www.idaho.gov/
Idaho Industrial Commissionhttp://www.iic.idaho.gov/
317 Main Street
Post Office Box 83720
Boise, Idaho 83720-0041
(800) 950-2110, (208) 334-6000; Fax: (208) 334-2321; TDD: (800)
950-2110
State Insurance Fundhttp://www.idahosif.org/
1215 West State Street
Post Office Box 83720
Boise, Idaho 83720-0044
(800) 334-2370, (208) 334-2370 (in the Boise area); Fax: (208) 334-2262
(Policyholder Services, Administration, Management Services, Legal), (208) 334-3253
(Claims), (208) 334-3254 (Underwriting); Fraud: (800) 448-ISIF (4743)
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Illinois
State of Illinoishttp://www.il.gov/
Illinois Workers’ Compensation Commissionhttp://www.iwcc.il.gov/
100 West Randolph Street, Suite 8-200
Chicago, Illinois 60601
(866) 352-3033 (toll free within Illinois), (312) 814-6611, Fax: (312)
814-6523, TDD: (312) 814-2959
E-mail:
infoquestions.wcc@illinois.gov
Click here to download free fillable PDF (Portable Document
Format) versions of Illinois workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Illinois Workers’
Compensation Commission Office of Self-Insurance Administrationhttp://www.iwcc.il.gov/selfinsurance.htm
E-mail: jean.cannon@illinois.gov
Springfield Office
701 South Second Street
Springfield, Illinois 62704
(217) 785-7084, Fax: (217)
785-6557
Chicago Office
100 West Randolph Street, Eighth floor
Chicago, Illinois 60601
(312) 814-6065
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Indiana
State of Indianahttp://www.in.gov/
Workers’ Compensation Board of Indianahttp://www.in.gov/workcomp/
Government Center South
402 West Washington Street, Room W-196
Indianapolis, Indiana 46204
(317) 232-3808; Claims/Statistics: (317) 233-4930; Fax: (317) 233-5493;
Insurance: (317) 233-3910; Ombudsman: (800) 824-COMP (2667), (317)
232-5922
Indiana Compensation Rating Bureau (ICRB)http://www.icrb.net/
Street Address:
5920 Castleway West Drive
Indianapolis, Indiana 46250
Mailing Address:
Post Office Box 50400
Indianapolis, Indiana 46250
(800) 622-4208, (317) 842-2800; Fax: (317) 842-3717
E-mail: icrb@icrb.net
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Iowa
State of Iowahttp://www.iowa.gov/
Iowa Workforce Developmenthttp://www.iowaworkforce.org/
1000 East Grand Avenue
Des Moines, Iowa 50319-0209
(800) JOB-IOWA, (515) 281-5387
Iowa Division of Workers’ Compensationhttp://www.iowaworkforce.org/wc/
1000 East Grand Avenue
Des Moines, Iowa 50319-0209
(800) JOB-IOWA (562-4692),
(515) 281-5387; Fax: (515) 281-6501, TTD: (515) 281-4748
E-mail: IWD.DWC@iwd.iowa.gov
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Kansas
State of Kansashttp://www.kansas.gov/
Department of Laborhttp://www.dol.ks.gov/
401 SW Topeka Boulevard
Topeka, Kansas 66603-3182
(785) 296-5000
Division of Workers’ Compensationhttp://www.dol.ks.gov/WC/HTML/wc_ALL.html
800 SW Jackson, Suite 600
Topeka, Kansas 66612-1227
(800) 332-0353, (785) 296-2996;
Fax: (785) 296-0839; Fraud: (800) 332-0353, (785) 296-6392;
Industrial Safety & Health: (800) 332-0353, (785) 296-4386;
Ombudsman: (800) 332-0353, (785) 296-2996
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Kentucky
Commonwealth of Kentuckyhttp://kentucky.gov/
Kentucky Department of Laborhttp://www.labor.ky.gov/
1047 U.S. 127 South, Suite 4
Frankfort, Kentucky 40601
(502)
564-3070, Fax: (502) 564-5387
Department of Workers’
Claimshttp://www.labor.ky.gov/workersclaims/
657 Chamberlin Avenue
Frankfort, Kentucky 40601
(502) 564-5550 (Administrative Services, Open Records); Fax: (502) 564-8250
(Administrative Services), (502) 564-9533 (Specialists), (502) 564-5732 (Open
Records), (502) 564-0916 (Security and Compliance)
Specialists Toll Free Number: (800) 554-8601
E-mail:
Department of Workers’ Claims
Click here to download free fillable PDF (Portable Document
Format) versions of Kentucky workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Workers’
Compensation Board—http://www.labor.ky.gov/workersclaims/workerscompboard.htm
(859) 246-2773, Fax:
(859) 246-2779
Division of Workers’ Compensation Funds—http://www.labor.ky.gov/ows/workerscompensationfunds/
1047 U.S. 127 South, Suite 4
Frankfort, Kentucky 40601
(502) 564-5467; Fax: (502) 564-5112
Workers’ Compensation Funding Commission—http://www.kwcfc.ky.gov/
Street Address:
#42 Millcreek Park
Frankfort, Kentucky 40601
Mailing Address:
Post Office Box 1228
Frankfort, Kentucky
40602-1228
(502) 573-3505,
Fax: (502) 573-4023
Kentucky Workers’ Compensation Law (via CompEd, Inc.)http://www.comped.net/
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Louisiana
State of Louisianahttp://www.louisiana.gov/wps/portal/
Department of Laborhttp://www.laworks.net/
Mailing Address:
Post Office Box 94094
Baton Rouge, Louisiana 70804-9094
Street Address:
1001 North 23rd Street
Baton Rouge, Louisiana 70804-9094
(225) 342-3111, TDD: (800) 259-5154
Office of Workers’ Compensation
Administrationhttp://www.laworks.net/wrk_owca.asp
Mailing Address:
Post Office Box 94040
Baton Rouge, Louisiana 70804-9040
Street Address:
1001
North 23rd Street
Baton Rouge, Louisiana 70802-9094
(225)
342-7555, Fax: (225) 342-5665, Fraud: (800) 201-3362 or WCFraud@ldol.state.la.us, Safety:
(800) 201-2497
E-mail: OWCA@ldol.state.la.us
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Maine
State of Maine—http://www.maine.gov/
Workers’ Compensation Board—http://www.maine.gov/wcb/
27 State House Station
Augusta, Maine 04333-0027
(207) 287-3751; Fax: (207) 287-7198
Click here to download free fillable PDF (Portable Document
Format) versions of Maine workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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Maryland
State of Marylandhttp://www.maryland.gov/
Maryland Workers’ Compensation Commissionhttp://www.wcc.state.md.us/
10 East Baltimore Street
Baltimore, Maryland 21202-1641
(800) 492-0479,
(410) 864-5100; Fax: (410) 333-8122; Fraud: (800) 846-4069;
info@wcc.state.md.us
Click here to download free fillable PDF (Portable Document
Format) versions of Maryland workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Insured Workers’ Insurance Fundhttp://www.iwif.com/
8722 Loch Raven Boulevard
Towson, Maryland 21286-2235
(800) 264-IWIF (4943), (410) 494-2000; Fax: (410) 494-2001;
Injury Reporting Hotline: (888) 410-1400; Fraud:
(888) ANTI-FRAUD (268-4372),
reportfraud@iwif.com
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Massachusetts
Commonwealth of Massachusettshttp://www.mass.gov/
Department of Industrial Accidentshttp://www.mass.gov/dia/
600 Washington Street, Seventh Floor
Boston, Massachusetts 02111
(800) 323-3249, (617) 727-4900; Fax: (617) 727-6477; TTY: (800)
224-6196
Click here to download free fillable PDF (Portable Document
Format) versions of Massachusetts workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Massachusetts Workers’ Compensation
Advisory Councilhttp://www.mass.gov/wcac/
600 Washington Street, Seventh Floor
Boston, Massachusetts 02111
(617) 727-4900, ext. 378; Fax: (617) 727-7122
Workers’
Compensation Rating and Inspection Bureau of Massachusetts—https://www.wcribma.org/mass/
101 Arch Street
Boston, Massachusetts 02110
(617) 439-9030, Fax: (617) 439-6055
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Michigan
State of Michiganhttp://www.michigan.gov/
Department of
Labor & Economic Growthhttp://www.michigan.gov/cis
Street Address:
611 W. Ottawa
Lansing, Michigan 48909
Mailing Address:
Post Office Box 30004
Lansing, Michigan 48909
(517) 373-1820, Fax: (517) 373-2129
Workers’ Compensation Agencyhttp://www.michigan.gov/wca
Street Address:
State Secondary Complex
General Office Building
7150 Harris Drive
1st Floor, B-Wing
Lansing, Michigan 48913
Mailing Address:
Post Office Box 30016
Lansing, Michigan 48909
(888) 396-5041,
(313) 456-2400,
Fax: (313) 456-2424
E-mail: wcinfo@michigan.gov
Click here to download free fillable PDF (Portable Document
Format) versions of Michigan workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Board of Magistrateshttp://www.michigan.gov/wca/0,1607,7-191-26919---,00.html
Post Office Box 30016
Lansing, Michigan 48909
(517) 241-9380, Fax: (517) 241-9379, TDD in Lansing: (517) 322-5987
Workers’
Compensation Appellate Commissionhttp://www.michigan.gov/cis/0,1607,7-154-10576_17495---,00.html
Street
Address:
Ottawa Building, 2nd Floor
611 West Ottawa Street
Lansing, Michigan 48909
Mailing
Address:
Post Office Box 30468
Lansing, Michigan 48909-7968
(517) 373-8020, Fax: (517)
241-1396
E-mail:
wcacinfo@michigan.gov
Michigan Economic
Development Corporationhttp://medc.michigan.org/
300 North Washington Square
Lansing, Michigan 48913
(888) 522-0103, (517) 373-9808
Michigan
Business Guide to Workers’ Compensationhttp://medc.michigan.org/services/workerscomp/
Compensation Cost Control Servicehttp://www.michigan.gov/wca/0,1607,7-191-26925-41305--,00.html
Victor Office Center, Fourth Floor
201 North Washington Square
Lansing, Michigan 48909-7968
(517) 373-9809, Fax: (517) 241-3689
Compensation Advisory
Organization of Michigan (CAOM)http://www.caom.com/
Street
Address:
17197 N. Laurel Park Drive, Suite 311
Livonia, Michigan 48152
Mailing Address:
Post Office Box 3337
Livonia, Michigan 48151-3337
(734) 462-9600, Fax: (734) 462-9721
Jerry J. Stage, President and Chief Executive Officer
Jon D. Heikkinen, Senior Vice President, CAOM
Operations
Gary L. Thompson, Vice President, Facility Operations
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Minnesota
State of Minnesotahttp://www.mn.gov/
Department of Labor and Industryhttp://www.dli.mn.gov/
443 Lafayette Road
North
St. Paul,
Minnesota 55155-4307
(800) DIAL-DLI (342-5354), (651)
284-5005; TTY: (651)
297-4198
Workers’ Compensation
Divisionhttp://www.dli.mn.gov/WorkComp.asp
443
Lafayette Road North
St. Paul, Minnesota 55155
(800) DIAL-DLI (342-5354)
in Greater Minnesota, (651) 284-5005 in the St.
Paul area, (800) 365-4584 or (218) 733-7810 in the Duluth area; Fax: (651)
284-5727
E-mail: DLI.Workcomp@state.mn.us
Click here to download free fillable PDF (Portable Document
Format) versions of
Minnesota workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Workers’ Compensation Court of Appealshttp://www.workerscomp.state.mn.us/
405 Minnesota Judicial Center
25 Dr. Martin Luther King Jr. Boulevard
St. Paul, Minnesota 55155
(651) 296-6526, Fax: (651) 297-2520, TTY/TDD: (800) 627-3529
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Mississippi
State of Mississippihttp://www.ms.gov/
Mississippi Workers’ Compensation Commissionhttp://www.mwcc.state.ms.us/
Street Address:
1428 Lakeland Drive
Jackson, Mississippi 39216
Mailing Address:
Post Office Box 5300
Jackson, Mississippi 39296-5300
(601) 987-4200, Fraud: (601) 359-4250
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Missouri
State of Missourihttp://www.mo.gov/
Department of Labor and
Industrial Relationshttp://www.dolir.missouri.gov/index.asp
Street Address:
3315 West Truman Boulevard, Room 213
Jefferson City, Missouri 65102
Mailing Address:
Post Office Box 504
Jefferson City, Missouri 65102-0504
(573) 751-9691, Fax: (573) 751-4135
- Division of Workers’
Compensationhttp://www.dolir.missouri.gov/wc/
Street Address:
3315 West Truman Boulevard, Room 131
Jefferson City, Missouri 65102
Mailing Address:
Post Office Box 58
Jefferson City, Missouri 65102-0058
(573) 751-4231, Fax: (573) 751-2012, Employee Hotline: (800) 775-2667,
Employer Hotline: (888) 837-6069,
Fraud and Noncompliance: (800)-592-6003, (573)-526-6630,
Workers’ Safety Program: (573) 526-3504
E-mail: Workerscomp@dolir.mo.gov
Click here to download free fillable PDF (Portable Document
Format) versions of Missouri workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
- Labor and Industrial Relations
Commissionhttp://www.dolir.state.mo.us/lirc/index.htm
3315 West Truman Boulevard
Jefferson City, Missouri 65102
or
Post Office Box 599
Jefferson City, Missouri 65102-0599
(573) 751-2461, Fax: (573) 751-7806
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Montana
State of Montanahttp://mt.gov/
Department of Labor and Industryhttp://dli.mt.gov/
Post Office Box 1728
Helena, Montana 59624-1728
(406) 444-2840, Fax: (406) 444-1394
E-mail: dliquestions@mt.gov
Employment Relations Divisionhttp://erd.dli.mt.gov/
Street Address:
Beck Building
1805 Prospect Avenue
Helena, MT 59624
Mailing Address:
Post Office 8011
Helena, MT 59604-8011
(406) 444-6543
Workers’
Compensation Claims Assistance Bureauhttp://erd.dli.mt.gov/wcca-bureau.html
Street Address:
Beck Building
1805 Prospect Avenue
Helena, Montana 59624
Mailing Address:
Post Office Box 8011
Helena, Montana 59624-8011
(406) 444-6543, Fax: (406) 444-3465, Mediation: (406) 444-6534, TDD: (406)
444-9696
E-mail: jakoehl@mt.gov
Workers’ Compensation Regulations Bureauhttp://erd.dli.mt.gov/workers-comp-regulations-bureau.html
Street Address:
Beck Building
1805 Prospect Avenue
Helena, Montana 59624
Mailing Address:
Post Office Box 8011
Helena, Montana 59624-8011
(406) 444-6541, Fax: (406) 444-3465
Workers’ Compensation
Courthttp://wcc.dli.mt.gov/
Street Address:
1625 11th Avenue
Helena, Montana
Mailing Address:
Post Office Box 537
Helena, Montana 59624-0537
(406) 444-7794, Fax:
(406) 444-7798
E-mail:
pkessner@state.mt.us
Montana State Fundhttp://www.montanastatefund.com/
Street Address:
855 Front Street
Helena, Montana 59601
Mailing Address:
Post Office Box 4759
Helena, Montana 59604-4759
Claim Reporting/Customer Service: (800) 332-6102 or (406) 444-6500, Fraud Reporting: (888) 682-7463,
TDD-TTY: (406) 495-5030
Montana Self-Insurers Guaranty Fund
5865 Rosendale Road
East Helena, MT 59635-9727
(406) 475-3766,
mtguarantyfund@mt.net
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Nebraska
State of Nebraskahttp://www.nebraska.gov/
Workers’ Compensation Courthttp://www.wcc.ne.gov/
Street Address:
Lincoln, Nebraska 68509
State House, 13th Floor
Mailing Address:
Post Office Box 98908
Lincoln, Nebraska 68509-8908
(800) 599-5155 (in Nebraska only), (402) 471-6468 (Lincoln and out of
state), Fax: (402) 471-2700
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Nevada
State of Nevadahttp://www.nv.gov/
Department of Business & Industryhttp://dbi.state.nv.us/
In Northern Nevada:
788 Fairview Avenue, Suite 100
Carson City, Nevada 89701-5491
(775) 687-4250, Fax: (775) 687-4266
E-Mail: biinfo@dbi.state.nv.us
In Southern Nevada:
555 E. Washington Avenue, Suite 4900
Las Vegas, Nevada 89101
(702) 486-2750, Fax: (702) 486-2758
E-Mail: biinfo@dbi.state.nv.us
Division of Industrial
Relationshttp://dirweb.state.nv.us/
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7260, Fax: (775) 687-6305
Industrial Insurance Regulation
Sectionhttp://dirweb.state.nv.us/iirs.htm
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7270, Fax: (775) 687-6305
Workers’ Compensation Section—http://dirweb.state.nv.us/WCS/wcs.htm
1301 North Green Valley Parkway, Suite 200
Henderson, Nevada 89074
(702) 486-9080, Fax: (702) 990-0364
E-mail: wcshelp@dbi.state.nv.us
Northern District:
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7270, Fax: (775) 687-6305
Southern District:
1301 North Green Valley Parkway, Suite 200
Henderson, Nevada 89074
(702) 486-9080, Fax: (702) 990-0364
Nevada Attorney for Injured
Workershttp://naiw.nv.gov/
2200 South Rancho Drive, Suite 230
Las Vegas, Nevada 89102
(702) 486-2830, Fax: (702) 486-2844
E-mail:
naiw@naiw.nv.gov
1000 East William Street, Suite 208
Carson City, Nevada
89701
(775) 684-7555, Fax: (775) 684-7575
E-mail:
naiw@naiw.nv.gov
EMPLOYERS Insurancehttp://www.employers.com
10375 Professional Circle
Reno, Nevada 89521-4802
Customer Service: (888) 682-6671, Fax: (888) 527-3422, E-mail:
renoinfo@employers.com; Fraud
Hotline: (800) 750-3939, E-mail:
fraudunit@employers.com; Loss Control: (800) 588-5200;
losscontrol@employers.com;
Audit/Collections: (800) 677-3252, E-mail:
customersupport@employers.com.
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New Hampshire
State of New Hampshirehttp://www.nh.gov/
Department of Laborhttp://www.labor.state.nh.us/
95 Pleasant Street
Concord, New Hampshire 03301
(603) 271-3177
Workers’ Compensation
Divisionhttp://www.labor.state.nh.us/workers_compensation.asp
95 Pleasant Street
Concord, New Hampshire 03301
(603) 271-3174 (claims), (603) 271-2042 (coverage), (603) 271-6172
(self-insurance), (603) 271-3328 (vocational rehabilitation)
Click here to download free fillable PDF (Portable Document
Format) versions of New Hampshire workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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New Jersey
State of New Jerseyhttp://www.state.nj.us/
Department of Laborhttp://www.state.nj.us/labor/
John Fitch Plaza
Post Office Box 110
Trenton, New Jersey 08625
(609) 292-2323, Fax: (609) 633-9271
Division of Workers’
Compensationhttp://www.nj.gov/labor/wc/wcindex.html
Post Office Box 381
Trenton, New Jersey 08625-0381
(609) 292-2515, Fax: (609) 984-2515
E-mail: dwc@dol.state.nj.us
Click here to download free fillable PDF (Portable Document
Format) versions of New Jersey workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
N.J. Compensation Rating and Inspection Bureauhttp://www.njcrib.com/
60 Park Place
Newark, New Jersey 07102
(973) 622-6014, Fax: (973) 622-6110
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New Mexico
State of New Mexicohttp://www.newmexico.gov/
Workers’ Compensation Administrationhttp://www.workerscomp.state.nm.us/
Mailing Address:
Post Office Box 27198
Albuquerque, New Mexico 87125-7198
Street Address:
2410 Centre Avenue SE
Albuquerque, New Mexico 87125
(800) 255-7965, (505) 841-6000, Fax: (505) 841-6009
Help
Line/Hot Line: (866) WORKOMP (967-5667), TTY/TDD: (505)
841-6043,
E-mail:
wca.hotline@state.nm.us
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New York
State of New Yorkhttp://www.ny.gov/
New York State Workers’ Compensation Boardhttp://www.wcb.state.ny.us/
20 Park Street
Albany, New York 12207
(877) 632-4996,
Fax: (518) 473-1415, Fraud: (888) 363-6001
E-mail:
general_information@wcb.state.ny.us
Click here to download free fillable PDF (Portable Document Format)
versions of New York workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
New York State Insurance Fundhttp://ww3.nysif.com/
199 Church Street
New York, New York 10007
(888) 875-5790, (212) 312-9000, Fax: (212) 385-2073
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North Carolina
State of North Carolinahttp://www.ncgov.com/
Department of Commercehttp://www.nccommerce.com/
Mailing Address:
4301 Mail Service Center
Raleigh, North Carolina 27699-4301
Street Address:
301 North Wilmington Street
Raleigh, NC 27020-0571
(919) 733-4151
E-mail: info@nccommerce.com
North Carolina Industrial Commissionhttp://www.ic.nc.gov/
Mailing
Address:
4340 Mail Service Center
Raleigh, North Carolina 27699-4340
Street Address:
Dobbs Building (sixth floor)
430 North Salisbury Street
Raleigh, North Carolina 27603-5937
(800) 688-8349, (919) 807-2501, Fax: (919) 715-0280,
InfoSpec@ic.nc.gov, Fraud:
fraudcomplaints@ic.nc.gov,
Safety: safety@ic.nc.gov
Fraud
Investigations Section: (888) 891-4895 (in North Carolina),
fraudcomplaints@ic.nc.govhttp://www.ic.nc.gov/fraud.html
Safety
Education Section: (919) 807-2603,
safety@ic.nc.govhttp://www.ic.nc.gov/safety.html
Workers’
Compensation Information Specialists Section (formerly Ombudsman
Section): (800) 688-8349,
InfoSpec@ic.nc.govhttp://www.ic.nc.gov/infospec.html
Click here to download free fillable PDF (Portable Document
Format) versions of North Carolina workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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North Dakota
State of North Dakotahttp://www.nd.gov/
Workforce Safety & Insurancehttp://www.WorkforceSafety.com/
1600 East Century Avenue, Suite One
Bismarck, North Dakota 58506-5585
(800) 777-5033, (701) 328-3800; Fax: (701) 328-3820; Fraud:
(800) 243-3331; Safety and Loss Prevention: (701) 328-3886; TDD: (701)
328-3786
E-mail: WorkforceSafety@wcb.state.nd.us
Workforce Safety & Insurance Board of Directors
Post Office Box 2174
Bismarck, North Dakota 58502-2174
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Ohio
State of Ohio—http://ohio.gov/
Ohio Bureau of Workers’ Compensation—http://www.ohiobwc.com/
30 West Spring Street
Columbus, Ohio 43215-2256
E-mail: Feedback@bwc.state.oh.us
(800) OHIOBWC (800-644-6292); Fax: (877) 520-OHIO (6446); TTY: (800)
BWC-4-TDD (800-292-4833); Authorized Consent for Release of Information:
Fax: (614) 621-3376; Ombudsman: (800) 335-0996, Fax: (614)
644-1998, Ombudsperson@bwc.state.us.us
Click here to download free fillable PDF (Portable Document
Format) versions of Ohio workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Industrial Commission of Ohiohttp://www.ohioic.com/index.jsp
30 West Spring Street
Columbus, Ohio 43215-2256
(800) 521-2691, (614) 466-6136, Fax: (614) 752-8304
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Oklahoma
State of Oklahomahttp://www.ok.gov/
Oklahoma
Workers’
Compensation Courthttp://www.owcc.state.ok.us/
Oklahoma
City Location:
Denver N.
Davison Court Building
1915 North Stiles Avenue
Oklahoma City, Oklahoma 73105
Tulsa Location:
440 South Houston, Suite 210
Tulsa, Oklahoma 74127
(800) 522-8210 (statewide), (405) 522-8600 (Oklahoma City) and
(918) 581-2714 (Tulsa), Fax: (405) 522-8687 (administration)
Department of Laborhttp://www.okdol.state.ok.us/
4001 North Lincoln Boulevard
Oklahoma City, Oklahoma 73105-5212
(888) 269-5353, (405)
528-1500 Fax: (405) 528-5751
Workers’ Compensation
Enforcement Unithttp://www.okdol.state.ok.us/workcomp/index.htm
Worker Safety Policy
Councilhttp://www.okdol.state.ok.us/wspc/index.htm
CompSource Oklahomahttp://www.compsourceok.com/
Mailing Address (Oklahoma City):
Post Office Box 53505
Oklahoma City, Oklahoma
73152-3505
Street Address (Oklahoma City):
1901 North Walnut Avenue
Oklahoma City, Oklahoma
73105-3295
(800) 347-3863, (405) 232-7663;
Teleclaim (to report an injury): (800) 872-7015; Claims Information:
(800) 462-7966, (405) 962-3872; Fax: (405) 962-3000, Fraud Hotline:
(800) 899-1847
Claims Information:
claims@compsourceok.com,
Fraud:
fraud@compsourceok.com
Street Addresses (Tulsa Branch Office):
1305 South Denver Avenue
Tulsa, Oklahoma
74119-3040
Mailing Address (Tulsa
Branch Office):
Post Office Box
50580
Tulsa,
Oklahoma 74150-0580
(800) 347-3863,
(918) 295-1500
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Oregon
State of Oregonhttp://www.oregon.gov/
Department of Consumer & Business
Serviceshttp://egov.oregon.gov/DCBS/
350 Winter Street NE
Salem, Oregon 97301-3878
(503) 378-4100, Fax: (503) 378-6444
Workers’ Compensation Divisionhttp://wcd.oregon.gov/
350 Winter Street NE, Room 27
Salem, Oregon 97301-3879
(800) 452-0288 (Workers’ Compensation Infoline); (503) 947-7810, Fax: (503)
947-7514; TTY: (503) 947-7993; Fraud Hotline: (800) 422-8778 (in
Oregon); Small Business Ombudsman: (503) 378-4209, Fax: (503) 373-7639;
Ombudsman for Injured Workers: (800) 927-1271, (503) 378-3351, Fax: (503)
373-7639
Workers’
Compensation Boardhttp://www.cbs.state.or.us/external/wcb/index.html
2601 25th
Street SE, Suite 150
Salem, Oregon 97302-1282
(503) 378-3308
Workers’
Compensation Management-Labor Advisory Committeehttp://www.oregon.gov/DCBS/MLAC/
Department of
Consumer & Business Services
350 Winter Street, Room 200
Salem,
Oregon 97301-3878
(503) 947-7867; Fax: (503) 378-6444
Ombudsman
for Injured Workers
http://egov.oregon.gov/DCBS/OIW/index.shtml
350 Winter Street
NE, Room 160
Salem, Oregon 97310
(800) 927-1271, (503)
378-3351
Ombudsman for
Small Businesshttp://egov.oregon.gov/DCBS/SBO/index.shtml
350 Winter Street
NE
Salem, Oregon 97301-3878
(503) 378-4209, V/TTY: (503) 378-4100
SAIF Corporationhttp://www.saif.com/
400 High Street
SE
Salem, Oregon 97312-1000
(800) 285-8525, (503)
373-8000
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Pennsylvania
State of Pennsylvaniahttp://www.pa.gov/portal/server.pt
Department of Labor and Industryhttp://www.dli.state.pa.us/
Labor & Industry Building
Room 1700
7th and Forster Streets
Harrisburg, Pennsylvania 17120
(717) 787-5279
Bureau of Workers’ Compensationhttp://www.dli.state.pa.us/landi/cwp/view.asp?a=138&q=220671
1171 South Cameron Street, Room
324
Harrisburg, Pennsylvania 17104-2501
(800) 482-2383
(inside Pennsylvania), (717) 772-4447 (local/out
of state), TTY: (800) 362-4228
(for hearing and speech impaired only)
E-mail: ra-li-bwc-helpline@state.pa.us
Click here to download free fillable PDF (Portable Document
Format) versions of Pennsylvania workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
State
Workers’ Insurance Fund—http://www.dli.state.pa.us/landi/cwp/view.asp?a=151&q=209835
Street Address
100 Lackawanna Avenue
Scranton,
Pennsylvania 18503
Mailing Address
Post Office Box 5100
Scranton, Pennsylvania 18505-5100
(570) 963-4635
E-mail:
ra-li-e-mail-swif@state.pa.us
Workers’ Compensation Appeal Board--http://www.dli.state.pa.us/landi/cwp/view.asp?a=296&q=202912
1171 South Cameron Street, Room 305
Harrisburg, Pennsylvania 17104-2511
(717) 783-7838, Fax: (717)
772-0343
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Rhode Island
State of Rhode Islandhttp://www.state.ri.us/
Workers’ Compensation Courthttp://www.courts.state.ri.us/workers/defaultnew-workers.htm
One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-5000, Fax:
(401) 222-3121
Medical
Advisory Boardhttp://www.courts.ri.gov/workers/medical/medical-advisory.htm
One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-3460
Workers’ Compensation Advisory Council
194 Smith Street
Providence, Rhode Island 02908
(401) 751-7100
Department of Labor and Traininghttp://www.dlt.ri.gov/
1511 Pontiac Avenue
Cranston, Rhode Island 02920-4407
(401) 462-8000
Workers’ Compensation Divisionhttp://www.dlt.ri.gov/wc/
Street Address:
1511 Pontiac Avenue, Building 69, Second Floor
Cranston, Rhode Island 02920-0942
Mailing Address:
Post Office Box 20190
Cranston, Rhode Island 02920-0190
(401) 462-8100, Fax: (401) 462-8105, TDD: (401) 462-8006
Click here to download free fillable PDF (Portable Document
Format) versions of Rhode Island workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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South Carolina
State of South Carolinahttp://www.sc.gov/
Workers’ Compensation Commissionhttp://www.wcc.sc.gov/
Street
Address:
1612 Marion
Street
Columbia, South Carolina 29201
Mailing Address:
Post Office Box 1715
Columbia, South Carolina 29202-1715
(803) 737-5700, Fax: (803) 737-5768
Click here to download free fillable PDF (Portable Document
Format) versions of South Carolina workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
South Carolina State Accident Fundhttp://www.saf.sc.gov/
Street
Address:
800 Dutch Square
Boulevard
Columbia, South Carolina 29221
Mailing Address:
Post Office Box 102100
Columbia, South Carolina 29221-5000
(800) 521-6576, (803) 896-5800
South Carolina Second Injury Fund--http://www.scsif.sc.gov/
220 Executive Center Drive
Winthrop Building, Suite 119
Columbia, South Carolina 29210
(803) 798-2722, Fax: (803) 798-5290
South Carolina Workers’ Compensation Uninsured Employers’ Fund
220 Executive Center Drive
Winthrop Building, Suite 119
Columbia, South Carolina 29210
(803) 798-2722, Fax: (803) 798-5290
South Carolina
Self-Insurers Association—http://www.scselfinsurers.com/
215 Holly Ridge Lane
West Columbia, SC 29169
(803) 794-2080, Fax: (803) 939-8366
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South Dakota
State of South Dakotahttp://www.sd.gov/
Department of Laborhttp://dol.sd.gov/
Workers’ Compensation
Programhttp://dol.sd.gov/workerscomp/default.aspx
Kneip
Building
700 Governors Drive
Pierre, South Dakota
57501-2291
E-mail: labor@dol-pr.state.sd.us
(605)
773-3681, Fax: (605) 773-4211
Workers’ Compensation Advisory Councilhttp://dol.sd.gov/workerscomp/advisorycouncil.aspx
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Tennessee
State of Tennesseehttp://www.tennessee.gov/
Department of Labor and Workforce Developmenthttp://www.tennessee.gov/labor-wfd/
Workers’ Compensation
Divisionhttp://www.state.tn.us/labor-wfd/wcomp.html
710 James Robertson Parkway
Gateway Plaza, Second Floor
Nashville, Tennessee 37243-0665
(800) 332-2667 (within Tennessee), (615) 532-4812, Fax: (615) 532-1468
Click here to download free fillable PDF (Portable Document
Format) versions of Tennessee workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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Texas
State of Texashttp://www.state.tx.us/
Department of Insurancehttp://www.tdi.state.tx.us/
Street Address
333 Guadalupe
Austin, Texas 78701
Mailing Address
Post Office Box 149104
Austin, Texas 78714-9104
(800) 578-4677, (512) 463-6169
Division
of Workers’ Compensationhttp://www.tdi.state.tx.us/wc/indexwc.html
7551
Metro Center Drive, Suite 100
Austin, Texas 78744-1609
Main number: (512) 804-4000; Commissioner’s office:
(512) 804-4435, fax: (512) 804-4401; Field Offices: (800) 252-7031
(local customer service); Fraud Hotline: (888) 327-8818 or (512)
804-4703; Safety Violations Hotline: (800) 452-9595; Technical Help
Desk (TXCOMP, EDI) (888) 4-TXCOMP
E-Mail:
WorkersCompCustomerServices@tdi.state.tx.us
Click here to download free fillable PDF (Portable Document Format)
versions of Texas workers’ compensation forms:
http://www.tdi.state.tx.us/forms/form20all.html.
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Utah
State of Utahhttp://www.utah.gov/
Labor Commissionhttp://www.laborcommission.utah.gov/
Division of
Industrial Accidentshttp://www.laborcommission.utah.gov/IndustrialAccidents/index.html
Mailing Address:
Post Office
Box 146610
Salt Lake City, Utah 84114-6610
Street Address:
160 East 300 South, 3rd Floor
Salt Lake City, Utah 84111
(800) 530-5090 (in state only), (801) 530-6800, Fax:
(801) 530-6804, TDD: (801) 530-7685
iaccd@utah.gov
Workers’ Compensation
Fundhttps://www.wcfgroup.com/wcfWebsite/homePage.do
Salt Lake City Office
392 East 6400 South
Murray, Utah 84107
(800) 446-2667
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Vermont
State of Vermonthttp://vermont.gov/
Department of Laborhttp://labor.vermont.gov/
Street Address
5 Green Mountain Drive
Montpelier, Vermont 05601-0488
Mailing Address
Post Office Box 488
Montpelier, Vermont 05601-0488
(802) 828-4000, Fax: (802) 828-4022
Workers’ Compensation & Safety Divisionhttp://labor.vermont.gov/Business/WorkersCompensation/tabid/114/Default.aspx
Street Address
5 Green Mountain Drive
Montpelier, Vermont 05601-0488
Mailing Address
Post Office Box 488
Montpelier, Vermont 05601-0488
(802) 828-2286, Fax: (802) 828-2195
Click here to download free fillable PDF (Portable Document
Format) versions of Vermont workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
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Virginia
Commonwealth of Virginiahttp://www.virginia.gov/
Virginia Workers’ Compensation Commissionhttp://www.vwc.state.va.us
1000 DMV Drive
Richmond, Virginia 23220
(877) 664-2566, Fax: (804) 367-9740, TDD: (804) 367-8600
E-mail: Questions@vwc.state.va.us
Click here to download free fillable PDF (Portable Document
Format) versions of Virginia workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
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Washington
State of Washingtonhttp://access.wa.gov/
Department of Labor and Industrieshttp://www.lni.wa.gov/
Labor and Industries Building
Post Office Box 44001
Olympia, Washington 98504-4001
(800) 547-8367, (360) 902-4200, Fax: (360) 902-4202
Workers’ Comp
Claimshttp://www.lni.wa.gov/ClaimsIns/Claims/default.asp
Board of Industrial Insurance Appealshttp://www.biia.wa.gov/
Street Address:
2430 Chandler Court, SW
Olympia, Washington 98504-2401
Mailing Address:
Post Office
Box 42401
Olympia, Washington 98504-2401
(800) 442-0447, (360) 753-9646, Fax: (360) 586-5611
Click here to download free fillable PDF (Portable Document Format)
versions of Washington workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
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West Virginiahttp://www.wv.gov/
Insurance Commissionhttp://www.wvinsurance.gov/
BrickStreet Mutual Insurance Companyhttp://www.brickstreet.com/
(formerly West Virginia Workers’ Compensation Commission)
Mailing Address:
Post Office Box 3824
Charleston, West Virginia 25338-3824
Street Address:
400
Quarrier Street
Charleston, West Virginia 25301
Administrative Services: (888)
4-WV-COMP and
(304)
926-3400, Fax: (304) 926-5372; Claims:
ClaimsInquiries@brickstreet.com; Fraud:
reportfraud@brickstreet.com;
Insurance: (866)
45BRICK (452-7425) and (304) 941-1000, Fax: (304)
304-941-1151; Providers:
ProviderInquiries@brickstreet.com; Safety Services:
SafetyServicesInquiries@brickstreet.com
Workers’
Compensation Office of Judgeshttp://www.wvinsurance.gov/ooj/
Mailing Address:
Post Office Box 2233
Charleston West Virginia 25328-2233
Street
Address:
One
Players Club Drive
Charleston West Virginia 25311-1638
(304) 558-1686, Fax:
(304) 558-1021
Workers’
Compensation Board of Review—http://www.wvinsurance.gov/boardofreview/index.htm
Mailing
Address:
Post Office Box 2628
Charleston,
West Virginia 25329-2628
Street Address:
104 Dee Drive
Charleston, West Virginia 25301
(304) 558-5230, Fax: (304) 558-1322
Workers’
Compensation Industrial Councilhttp://www.wvinsurance.gov/wc/industrialcouncil/index.htm
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Wisconsin
State of Wisconsinhttp://www.wisconsin.gov/state/home
Department of Workforce Developmenthttp://www.dwd.state.wi.us/
Workers’ Compensation
Divisionhttp://www.dwd.state.wi.us/wc/default.htm
Mailing
Address:
Post Office Box
7901
Madison, Wisconsin 53707-7901
Street Address:
Room C100
201 East Washington Avenue
Madison, Wisconsin 53703
(608) 266-1340; Fax: (608) 267-0394; Fraud (608) 261-8486
Click here to download free fillable PDF (Portable Document
Format) versions of Wisconsin workers’
compensation forms courtesy Interface
Technologieshttp://www.interfacetec.com/
Workers’ Compensation
Advisory Councilhttp://www.dwd.state.wi.us/wc/councils/wcac/default.htm
(608) 266-6841
Frances
Huntley-Cooper,
Chairman
Wisconsin
Compensation Rating Bureauhttps://www.wcrb.org/WCRB/wcrbhome.htm
Mailing Address:
Post Office Box 3080
Milwaukee, WI 53201-3080
Street Address:
20700 Swenson Drive, Suite 100
Waukesha, Wisconsin 53186
(262) 796-4540, Fax: (262) 796-4400
Wisconsin Labor and Industry Review
Commissionhttp://www.dwd.state.wi.us/lirc/
Mailing Address:
Post Office Box 8126
Madison, Wisconsin 53708-8126
Street Address:
Wisconsin Public Broadcasting Building
3319 West Beltline Highway
Madison, Wisconsin
(608) 266-9850 Fax: (608) 267-4409
E-mail: dwdlirc@dwd.state.wi.us
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State of Wyoming—http://wyoming.gov/
Department of Employmenthttp://wydoe.state.wy.us/
Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, Wyoming 82002
(307) 777-7672, Fax: (307) 777-5805
Cindy
Pomeroy, Director, (307) 777-5960, CPOMER@state.wy.us
Charles Rando, Administrator, (307) 777-6370,
CRANDO@state.wy.us
Workers’ Safety and Compensation Division—http://wydoe.state.wy.us/doe.asp?ID=9
Cheyenne
Business Center
1510 East Pershing Boulevard
Cheyenne, Wyoming 82002
(307)
777-7159, Fax: (307) 777-5524.
To Report an Injury: (800) 870-8883 or (307)
777-7441, Fax: (307) 777-6552.
To Report Fraud: (888) 996-9226
or (307) 777-6552, Fax: (307) 777-3581.
Gary
Child, Administrator, (307) 777-7159, Fax: (307) 777-5524, GCHILD@state.wy.us
Employment Tax Divisionhttp://wydoe.state.wy.us/doe.asp?ID=10
Post Office Box 2760
Casper, Wyoming 82602-2760
(307) 235-3201 (Casper) or (307) 777-7471 (Cheyenne)
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Other U.S. Areas
American Samoa
American Samoahttp://www.government.as/
Workmen’s Compensation Commission
Office of the Governor
Pago Pago, American Samoa 96799
(684) 633-4116
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Guam
Government of Guamhttp://www.guam.gov/
Department of Labor/Agency for Human
Resources Developmenthttp://www.dol.guam.gov/
Workers’ Compensation Commissionhttp://www.guamdol.net/content/view/27/83/
Street Address:
414 West Soledad Avenue
GCIC Building
Hagatna, Guam 96910
Mailing Address:
Post Office Box 9970
Tamuning, Guam 96931-9970
(671) 475-7033 and
(671) 475-7034, Fax: (671) 475-7026
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Navajo Nation
Navajo Nationhttp://www.navajo.org/
Workers’ Compensation Program
Post Office Box 2489
Window Rock, Arizona 86515
(928) 871-6389, Fax: (928) 871-6087
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Northern Mariana Islands
Commonwealth of the Northern Mariana Islandshttp://www.gov.mp/
Caller Box 10,007
Saipan, MP 96950
USA
(670) 664-2200
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Puerto Rico
Puerto Ricohttp://www.gobierno.pr/
Comisión
Industrial de Puerto Ricohttp://www.cipr.gobierno.pr/
Post
Office Box 364466
San Juan, Puerto Rico 00936-4466
(787) 781-0545, Fax: (787) 783-5610
E-mail: contacto@cipr.gobierno.pr
State Insurance Fund
Post Office Box 5028
San Juan, Puerto Rico 00936
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Virgin Islands
Virgin Islandshttp://www.usvi.org/
Department of Laborhttp://www.vidol.gov/
St. Croix (Main Office)
302 King Street
St. Croix, Virgin Islands 00840-4612
(340) 773-1994, Fax: (340) 772-3365
St. Thomas (Main Office)
Post Office Box 302608
St. Thomas, Virgin Islands 00803-2608
(340) 776-3700, Fax: (340) 774-5908
Workers’ Compensation Administrationhttp://www.vidol.gov/Units/Workers_Compensation/Workers_Comp.htm
3012 Vitraco Mall, Golden Rock
Christiansted
St. Croix, Virgin Islands 00820-4666
(809) 692-9390, Fax: (809) 773-4338
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N.C. Industrial Commission ·
4340 Mail Service Center ·
Raleigh, NC 27699-4340
Main Telephone: (919) 807-2500 ·
Fax: (919) 715-0280
NCIC Home Page: http://www.ic.nc.gov/