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 United States and Canadian 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.
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 28 March 2013. 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
Canada: Federal Jurisdiction Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Ontario Prince Edward Island Québec Saskatchewan Yukon Territory
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
Hilda
L. Solis, Secretary, (202) 693-6000
Seth
D. Harris,
Deputy Secretary, (202) 693-6000
Katherine Archuleta,
Chief of Staff, (202) 693-6000
Deborah Greenfield, Executive Secretariat
Director, (202) 693-6100
Carolyn Mosley, Director of Advance & Scheduling, (202)
693-6003
Alex Mas, Chief Economist, (202)
693-6000
Office of Workers’
Compensation Programs (OWCP)—http://www.dol.gov/owcp/
(202) 219-0031, TTY:
(877) 889-5627
Shelby Hallmark, Director, (202) 693-0031
Nancy Flynn, Deputy Director, (202) 693-0031
Cecily Rayburn, Director, Division of Planning,
Policy, and Standards, (202) 693-0032
Douglas C. Fitzgerald, Director, Federal Employees’
Compensation, (202) 693-0040
Rachel P. Leiton, Director, Energy Employees
Occupational Illness Compensation, (202) 693-0081
Michael Niss, Director, Longshore and Harbor
Workers’ Compensation, (202) 693-0038
James L. DeMarce, Director, Coal Mine
Workers’ Compensation, (202) 693-0046
OWCP Regional Directors
Northeast Region
(consists of New
York and Boston
district offices)
Robert Sullivan, Regional
Director
201 Varick Street, Room 740
New York, New York 10014
(646)
264-3100
Philadelphia
Region
R. David Lotz, Regional Director
170 S. Independence Mall West, Suite 780
West
Philadelphia, Pennsylvania 19106-3313
(215) 861-5401, Fax: (215) 861-5400
Atlanta
Region (consists of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South
Carolina, and Tennessee)
Richard Brettell,
Regional Director
Charles E. Bennett Federal Building
214 North Hogan Street, Room 1026
Jacksonville,
Florida 32202
(904) 357-4777
Midwest
Region (consists of Chicago,
Cleveland, and
Kansas City district offices)
Nancy Jenson, Regional Director
230 South Dearborn Street, 8th Floor
Chicago,
Illinois 60604
(312) 596-7131
Southwest
Region (consists of Dallas
and Denver district offices)
E. Martin Walker, Regional Director
Federal Building
525 South Griffin Street, Room 407
Dallas, Texas 75202
(972) 850-2409
Pacific
Region
(consists of the San Francisco and
Seattle district offices)
Sharon Tyler, Regional Director
90 7th Street, Suite 15100
San Francisco, California 94103
(415) 625-7575
Alabama
State of Alabama—http://www.al.gov/
Department of Industrial Relations—http://dir.alabama.gov/
Phyllis
Kennedy,
Director, (334) 242-8990, Fax: (334) 242-3960, Director@dir.state.al.us
Donald
K. Fisher, Assistant Director, (334) 242-8990,
Fax: (334) 242-3960, DFisher@dir.state.al.us
Workers’ Compensation Division—http://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)
Scottie
Spates, Director, Administrative Section, (800) 528-5166, (334)
353-0990, Fax: (334) 353-8262, WC@dir.state.al.us
Alaska
State of Alaska—http://www.state.ak.us/
Department of
Labor and Workforce Development—http://www.labor.state.ak.us/home.htm
Workers’ Compensation Division—http://www.labor.state.ak.us/wc/wc.htm
Post Office Box 25512
Juneau, Alaska 99802-5512
(907) 465-2790; Fax: (907)
465-2797
Paul L. Grossi, Director,
(907) 465-6046, Fax: (907) 465-2797, Paul_Grossi@labor.state.ak.us
Mark R. Torgerson, Chief of Adjudications,
(907) 269-4982, mark_torgerson@labor.state.ak.us
Workers’
Compensation Board—http://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
Commissioner of Labor Ed Flanagan,
Chairman Commissioner_Labor@labor.state.ak.us
John A. Abshire, At Large/Labor
Valerie K. Baffone, 3rd Judicial
District/Labor
Dorothy Bradshaw, 2nd/4th
Judicial District/Industry
John Giuchici,
2nd/4th Judicial District/Labor
Paul Grossi,
Commissioner of Labor or his designee
Steve
Hagedorn, 3rd Judicial District/Industry
Harriet M. Lawlor, 3rd Judicial
District/Labor
Andrew J. Piekarski, 3rd
Judicial District/Labor
Nancy Jo Ridgley, 1st
Judicial District/Labor
Florence S. Rooney,
3rd Judicial District/Industry
Marc D. Stemp,
At Large/Industry
Philip E. Ulmer, 3rd
Judicial District/Industry
James G. Williams,
1st Judicial District/Industry
Arizona
State of Arizona—http://www.state.az.us/
Industrial Commission of Arizona—http://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
Gay Conrad Kruglick, Chairman
Mike Petchel, Vice Chairman
Jean-Pierre Angelchick, M.D., Commissioner
Sandy Grunow, Commissioner
Lou Rodriguez, Commissioner
Larry J. Etchechury, Director
Teresa Hilton, Secretary
Click here to download free fillable PDF (Portable Document
Format) versions of Arizona workers’
compensation forms courtesy Interface
Technologies—http://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
Donald A. Smith, Jr., President and
CEO
Arkansas
State of Arkansas—http://www.state.ar.us/
Workers’ Compensation Commission—http://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; Special Funds Direct: (866) 880-8444; TDD: (800) 285-1131; Arkansas Relay System TDD: (800)
285-1131
A. Watson Bell,
Chairman, awbell@awcc.state.ar.us
Karen H. McKinney, Commissioner,
kmckinney@awcc.state.ar.us
Philip A. Hood, Commissioner,
phood@awcc.state.ar.us
Alan McClain, Chief Executive
Officer, amcclain@awcc.state.ar.us
James W. Daniel, Assistant Chief Executive
Officer, jdaniel@awcc.state.ar.us
David Greenbaum, Chief Administrative Law Judge,
dgreenbaum@awcc.state.ar.us
California
State of California—http://www.ca.gov/
Department of
Industrial Relations—http://www.dir.ca.gov/
Christine Baker, Acting Director
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
Chairman
Angie
Wei, Labor Representative
Commission
Members: http://www.dir.ca.gov/chswc/Members.htm
Catherine
“Cathy” Aguilar,
Employer Representative
Allen
Davenport, Labor Representative
Sean
McNally, Employer Representative
Kristen
Schwenkmeyer, Employer Representative
Robert
B. Steinberg, Employer Representative
Darrel
“Shorty” Thacker, Labor Representative
Christine Baker,
Executive Officer,
(510) 622-3959, Fax: (510) 622-3265
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
Rosa Moran, Administrative Director
Keven Star, Court Administrator
Click here to download free fillable PDF (Portable Document
Format) versions of California workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Division
of Workers’ Compensation Medical Unit—http://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
Anne
Searcy, MD, Executive Medical Director
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
Commissioners
Joseph M. Miller, Chairman, (415) 703-4554
Frank M. Brass, Commissioner
Ronnie Caplane, Commissioner
James C. Cuneo, Commissioner
Alfonso J. Moresi, Commissioner
Janice Murray, Commissioner
William K. O’Brien, Commissioner
Deputy Commissioners
Dennis J. Hannigan, Secretary
Rick Dietrich, Assistant Secretary
Neil P. Sullivan, Assistant Secretary
Self-Insurance Plans (SIP)—http://www.dir.ca.gov/SIP/
2265 Watt Avenue, Suite 1
Sacramento, California 95825
(916) 574-0300, Fax: (916)
483-1535
E-mail: SIP@dir.ca.gov
Mark Johnson, Chief
James Ware, Manager
Jamie Meyers, Marilee Robinson, and Ken Swanson, Supervisors
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
Janet
Frank,
President
James F. Neary and John E. Putnam,
Executive Vice Presidents
Connie Raiche, Don L. Smith, Harrison
D. Jerome, Linda T. Hoban, Nancy A. Obertello, and David
West,
Vice Presidents
Directors
Jeanne Cain, Chair of the Board and Senior Vice
President of the California Chamber of Commerce
Sheryl Chalupa, President and Chief Executive Officer
of Goodwill Industries of South Central California and Vice Chair of California
Council of Goodwill Industries
Vincent Mudd, President and Chief Executive Officer of
San Diego Office Interiors
Francis Quinlan, Partner in Kester & Quinlan, LLP
James A. Santangelo, President of Joint Council 42 of
the Teamsters Union and Secretary-Treasurer of Local 848
Ex-officio Board Members
John C. Duncan, Director of the Department of
Industrial Relations
Jay Hansen, designee of the Assembly and Legislative
Director of the State Building & Construction Trades Council
Don Moulds, designee of the Senate and Vice President
of Medical & Regulatory Policy, California Medical Association
Colorado
State of Colorado—http://www.colorado.gov/
Department of Labor &
Employment—http://www.coworkforce.com/
633 17th Street, Suite 200
Denver, Colorado 80202-3660
Donald
J. Mares, Executive Director, (303)
318-8020
Division of Workers’ Compensation—http://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
Bob Summers, Director, (303)
318-8014
Paul Tauriello,
Deputy Director, (303) 318-8650
Click here to download free fillable PDF (Portable Document
Format) versions of Colorado workers’
compensation forms courtesy Interface
Technologies—http://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
Dona Halsey, Director
Connecticut
State of Connecticut—http://www.ct.gov/
Workers’ Compensation Commission—http://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
John A. Mastropietro, Chairman
Amado J. Vargas, Commissioner
Stephen B. Delaney, Commissioner
Ernie R. Walker, Commissioner
Charles F. Senich, Commissioner
Michelle D. Truglia, Commissioner
Nancy E. Salerno, Commissioner
Scott A. Barton, Commissioner
Peter Mlynarczyk, Commissioner
Jack R. Goldberg, Commissioner
Randy L. Cohen, Commissioner
Jodi Murray Gregg, Commissioner
Christine L. Engel, Commissioner
Daniel E. Dilzer, Commissioner
David W. Schoolcraft, Commissioner
Clifton E. Thompson, Commissioner
Marvin L. Smernoff, Chief Administrative Officer
Click here to download free fillable PDF (Portable Document
Format) versions of Connecticut workers’
compensation forms courtesy Interface
Technologies—http://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
John A. Mastropietro,
Chairman
Delaware
State of Delaware—http://delaware.gov/
Department of Labor—http://www.delawareworks.com/
4425 North Market Street
Wilmington, Delaware 19802
dlabor@state.de.us
Thomas
B. Sharp, Secretary, (302) 761-8000, Fax: (302) 761-6621
Division of
Industrial Affairs—http://www.delawareworks.com/industrialaffairs/
4425
North Market Street, Third Floor
Wilmington, Delaware 19802
(302) 761-8200 (New Castle), (302) 422-1134 (Kent and Sussex)
John Kirk III, Director, (302)
761-8176, Fax: (302) 761-6601,
john.kirk@state.de.us
Office of Workers’ Compensation—http://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
John F. Kirk, III,
Deputy Director
Lowell L. Groundland, Chair
Harold B. Barber, Member
Elaine Bowen, Member
John D. Daniello, Member
Mary L. Dantzler, Member
Marilyn Doto, Member
Victor Epolito, Member
Alice Mitchell, Member
Romayne Seward, Member
Terrence Shannon, Member
District of Columbia
District of Columbia—http://www.dc.gov/
Department of Employment Services—http://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
Reginald H. Berry, Assistant Director
Office of Workers’ Compensation—http://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
Charles L. Green, Associate Director
Office
of Hearings and Adjudication—http://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
Malcolm J. Luis-Harper, Chief Administrative
Law Judge
Florida
State of Florida—http://www.myflorida.com/
Florida Department of Financial Services—http://www.myfloridacfo.com/
Alex
Sink, Chief Financial Officer,
Alex.Sink@myfloridacfo.com
200 East Gaines Street
Tallahassee, FL 32399-0300
(850) 413-3100, Consumer Helpline: (800) 342-2762
Division of Workers’ Compensation—http://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
Tanner Holloman, Director, (850) 488-2514,
Tanner.Holloman@myfloridacfo.com
Andrew Sabolic, Assistant Director, Andrew.Sabolic@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 Hearings—http://www.doah.state.fl.us/internet/
The Desoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32301-3060
(850) 488-9675; Fax: (850) 921-6847
Robert S. Cohen, Director and Chief Judge
Claudia Llado, Clerk of the Division,
Claudia_Llado@doah.state.fl.us
Office of Judges of
Compensation Claims—http://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
David
W. Langham, Deputy Chief Judge
Florida Department of Education—http://www.fldoe.org/
Florida Division of Vocational
Rehabilitation—http://www.rehabworks.org/
2002 Old Saint
Augustine Road, Building A
Tallahassee, Florida 32301-4862
(800) 451-4327 (Voice/TDD), (850) 245-3399
(Voice/TDD)
Bill Palmer, Director
Georgia
State of Georgia—http://www.georgia.gov/
Georgia State Board of Workers’ Compensation—http://sbwc.georgia.gov/portal/site/SBWC/
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
Richard S. Thompson, Chairman, (404) 656-2034
Stephen B. Farrow, Director, (404) 656-2038
Warren Massey, Director, (404) 656-2036
Stan Carter, Executive Director and Chief Operating Officer, (404) 656-2048
Thomas M. Risko, Chief Financial Officer, (404) 656-2314
Marianne McMillan, Director, Licensure and Self-Insurance, (404) 656-4893
Click here to download free fillable PDF (Portable Document
Format) versions of Georgia workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Georgia Subsequent Injury Trust Fund—http://sitf.georgia.gov/portal/site/SITF/
Marquis Two Tower, Suite 1250
285 Peachtree Center Avenue NE
Atlanta, Georgia 30303
(404) 656-7000, Fax: (404) 206-656-7100
Mike Coan, Administrator, (404) 656-7013, mcoan@sitf.ga.gov
Allan Payne, Deputy Administrator, (404) 656-7062, apayne@sitf.ga.gov
Kathy Cannon, Director of Administrative Services, (404) 656-7022, kcannon@sitf.ga.gov
Hawaii
State of Hawaii—http://www.hawaii.gov/portal/
Department of Labor & Industrial Relations
(DLIR)—http://hawaii.gov/labor/
Nelson
B. Befitel, Director, (808) 586-8844, Fax:
(808) 586-9099, dlir.director@hawaii.gov
830 Punchbowl Street
Honolulu, Hawaii 96813
(808) 586-8842, Fax: (808) 586-9099, dlir.director@hawaii.gov
Disability Compensation Division—http://hawaii.gov/labor/dcd/index.shtml
830 Punchbowl Street, #211
Honolulu, Hawaii 96813
(808) 586-9151, Fax: (808) 586-9219, dlir.workcomp@hawaii.gov
Gary Hamada, Administrator
Labor & Industrial Relations Appeals Board—http://hawaii.gov/labor/hlirab/index.shtml
830 Punchbowl Street #404
Honolulu, Hawaii 96813
(808) 586-8600,
Fax: (808) 586-8599, dlir.laborboard@hawaii.gov
Randall Iwase, Chairman
Idaho
State of Idaho—http://www.idaho.gov/
Idaho Industrial Commission—http://www.iic.idaho.gov/
Street Address:
317 Main Street
Boise, Idaho 83720
Mailing Address:
Post Office
Box 83720
Boise, Idaho 83720-0041
(800) 950-2110, (208)
334-6000; Fax: (208) 334-2321; TDD: (800) 950-2110
Thomas Limbaugh, Chairman (employer representative), (208)
334-6000
James F. Kile, Commissioner (attorney representative), (208)
334-6000
R. D. Maynard, Commissioner (employee representative), (208)
334-6000
Mindy Montgomery, Director, (208)
334-6059
Nancy Beeson, Secretary, (208)
334-6017, nbeeson@iic.idaho.gov
State Insurance Fund—http://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)
E-mail addresses:
Claims: Claims@isif.state.id.us
Customer Service Center: CustomerService@isif.state.id.us
Fraud: Claims@isif.state.id.us
General Information/News Media Inquiries: abunch@isif.state.id.us
Management Services: ManagementServices@isif.state.id.us
Manager’s Office: Administration@isif.state..id.us
Policyholder Services: PHS@isif.state.id.us
Underwriting: Underwriting@isif.state.id.us
Illinois
State of Illinois—http://www.il.gov/
Illinois
Workers’ Compensation Commission—http://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
Commissioners
Mitch Weisz, Chairman, (312) 814-6560, nicholas.velazquez@illinois.gov
Mario Basurto, Commissioner, (312) 814-5641, marcia.monroe@illinois.gov
Yolaine Dauphin, Commissioner, (312) 814-1110, serina.jenkins@illinois.gov
Charles DeVriendt, Commissioner, (312) 814-6606,
joanne.cozzo@illinois.gov
Dan Donohoo, Commissioner, (312) 814-6058, wayland.johnson@illinois.gov
David Gore, Commissioner, (312) 814-1211, gina.a.logalbo@illinois.gov
Kevin Lamborn, Commissioner, (312) 814-1522, vivian.frederick@illinois.gov
Michael Latz, Commissioner, (312) 814-6601, barbara.galazkiewicz@illinois.gov
Thomas Tyrrell, Commissioner, (312) 814-6603, yvonne.laws@illinois.gov
Ruth White, Commissioner, (312) 814-1157, loretta.jackson@illinois.gov
Administrators
Kimberly Janas, Secretary of the Commission/Chief of Staff, (312) 814-6559, kimberly.janas@illinois.gov
Commission Review Board: http://www.iwcc.il.gov/boards.htm#CRB
Self-Insurers Advisory Board: http://www.iwcc.il.gov/boards.htm#ISIAB
Workers’ Compensation Advisory Board: http://www.iwcc.il.gov/boards.htm#WCAB
Workers’ Compensation Medical Fee Advisory Board: http://www.iwcc.il.gov/boards.htm#WCMFAB
Click here to download free fillable PDF (Portable Document
Format) versions of Illinois
workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Illinois Workers’
Compensation Commission Office of Self-Insurance Administration—http://www.iwcc.il.gov/selfinsurance.htm
E-mail: jean.cannon@illinois.gov
Maria
Sarli-Dehlin, Manager of Self-Insurance,
(312)
814-6065, maria.dehlin@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
Indiana
State of Indiana—http://www.in.gov/
Workers’ Compensation Board of Indiana—http://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
G. Terrence Coriden, Chairman, (317)
232-3808
Rogelio Dominquez, Member,
(317) 232-5922
Douglas Meagher,
Member, (317) 233-5397
Richard J.
Noel, Member, (317) 233-3906
Linda
Powell, Member, (317) 233-3908
John
Rader, Member, (317) 233-3904
Anne
Thomas, Member, (317) 232-5922
Sandy
Cerimele Fralich, Executive Secretary, (317) 232-3809
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
Ronald W. Cooper, CWCP, President,
rcooper@icrb.net
Iowa
State of Iowa—http://www.iowa.gov/
Iowa Workforce Development—http://www.iowaworkforce.org/
1000 East Grand Avenue
Des Moines, Iowa 50319-0209
(800) JOB-IOWA, (515) 281-5387
Elisabeth Buck, Director
Iowa Division of Workers’ Compensation—http://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
Christopher J. Godfrey, Workers’ Compensation
Commissioner,
Christopher.Godfrey@iwd.iowa.gov
Janna E. Polite, Assistant Workers' Compensation Commissioner,
Janna.Polite@iwd.iowa.gov
Sharon K. Ortega, Administrative Secretary,
Sharon.Ortega@iwd.iowa.gov
Kansas
State of Kansas—http://www.kansas.gov/
Department of Labor—http://www.dol.ks.gov/
401 SW Topeka Boulevard
Topeka, Kansas 66603-3182
(785) 296-5000
Jim
Garner, Secretary
Division of Workers’ Compensation—http://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
Paula Greathouse, Director, (785) 296-2996
Kentucky
Commonwealth of Kentucky—http://kentucky.gov/
Kentucky Department of Labor—http://www.labor.ky.gov/
1047 U.S. 127 South, Suite 4
Frankfort, Kentucky 40601
(502)
564-3070, Fax: (502) 564-5387
J.R. Gray, Secretary, (502) 564-0685, Fax:
(502) 684-5387
Department of Workers’
Claims—http://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
Dwight
T. Lovan,
Commissioner, (502) 782-4439; Fax: (502) 564-5934
Wayne Logan, Deputy Commissioner, (502) 782-4482; Fax:
(502) 564-5934
John Burkholder, Director of Security and Compliance,
(502) 782-4534; Fax: (502) 564-0916
Ingrid Bowling, Director of Claims Processing and Appeals,
(502) 782-4418; Fax: (502) 564-3792
Fran Davis, Director of Information and Research,
(502) 782-4578; Fax: (502) 564-5732
Lucretia Johnson, Director of Specialists Services Division,
(502) 782-4559; Fax: (502) 564-9533
Scott Borders, Acting Chief Administrative Law Judge,
(502) 782-4446, Fax: (502) 564-0682
John W. Mann, Chief Workers' Compensation Specialist,
(502) 782-4532; Fax: (502) 564-9533
Charlie Lowther, General Counsel, (502) 782-4464; Fax:
(502) 564-5934
Click here to download free fillable PDF (Portable Document
Format) versions of Kentucky workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Workers’
Compensation Board—http://www.labor.ky.gov/workersclaims/workerscompboard.htm
Michael W. Alvey,
Chairman, (270) 926-9494
Franklin A. Stivers, Member, (606) 330-2171
Bruce Cowden, Member, (859) 246-2773
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
Robert L. Whittaker, Director,
(502) 564-3083; 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
Gordon Stammel,
(502) 573-3505, ext. 228;
Gordon.Stammel@ky.gov
Kentucky Workers’ Compensation Law (via CompEd, Inc.)—http://www.comped.net/
Louisiana
State of Louisiana—http://www.louisiana.gov/wps/portal/
Department of Labor—http://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
John Warner Smith, Secretary of Labor
Office of Workers’ Compensation
Administration—http://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
Karen Reiners Winfrey, Assistant Secretary of Labor
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
Board of Directors
Paul R. Dionne, Chair, (207)
287-7086
Management Representatives
James
A. Mingo, Board
Member, (207) 287-7096
Mitchell P. Sammons, Board Member, (207) 287-7096
Sophia Wilson, Board Member, (207) 287-7096
Labor Representatives
Daniel Lawson, Board
Member, (207) 287-7096
Anthony Monfiletto, Board Member, (207)
287-7096
Ginette Rivard, Board Member, (207)
287-7096
Staff Members
Paul R. Dionne, Executive Director, (207)
287-7086
Richard Dunn, Deputy Director, Business
Services, (207) 287-7083
Steven P. Minkowsky, Deputy Director, Monitoring, Audit, and Enforcement Program,
(207) 287-7067,
steven.minkowsky@maine.gov
Elizabeth Inman, Deputy Director, Office of Medical Rehabilitation Services,
(207) 941-4557, betty.inman@maine.gov
John Rohde, General Counsel, (207)
287-7086
Click here to download free fillable PDF (Portable Document
Format) versions of Maine workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Maryland
State of Maryland—http://www.maryland.gov/
Workers’ Compensation Commission—http://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
R.
Karl Aumann, Chairman, (410) 864-5300
Patricia G. Adams, Commissioner, (410) 864-5365
Jeffrey C. Herwig, Commissioner, (410) 864-5179
Kenneth G. Macleay, Commissioner, (410) 864-5135
Cynthia S. Miraglia, Commissioner, (410) 864-5130
Maureen Quinn, Commissioner, (410) 864-5270
Lauren Sfekas, Commissioner, (410) 864-5238
Kimberly Smith Ward, Commissioner, (410) 864-5112
John R. Webster, Jr., Commissioner, (410) 864-5340
Jeffrey T. Weinberg, Commissioner, (410) 864- 5276
Mary K. Ahearn, Executive Director of Administration,
(410) 864-5308
Click here to download free fillable PDF (Portable Document
Format) versions of Maryland workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Insured Workers’ Insurance Fund—http://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
Thomas J. Phelan,
CPA, President and Chief Executive Officer
Paige Beck, CPA, Executive Vice President and Chief
Financial Officer
Dennis W. Carroll, Esq., Executive Vice President and
General Counsel
Robert E. Merritt, CFA, Executive Vice President and
Chief Investment Officer
George H. Matthews, AAI, Executive Vice President,
Insurance Operations
Timothy K. Michels, Esq., Executive Vice President,
Claims
Rona S. Finkelstein, Esq., Senior Vice President,
Legal Services & Human Resources
Donna C. Wilson, Senior Vice President, Strategic
Planning and Communications
Rial R. Simons, FCAS, MAAA, Chief Actuary
Elbert Danquah, Vice President, Internal Audit
Kama Kolbe, Vice President, Underwriting
Frank Linardi, Jr., CPA, Vice President, Finance and
Controller
Robert Marshall, Vice President, Information Systems
Nancy Wilson, Vice President, Claims
Board of Directors
Rocky V. Gonzalez, Chairman
R. Bruce Alderman, Esq., Vice Chairman
Patricia McHugh Lambert, Secretary
Frank D. Boston, Jr., Treasurer
Joseph M. Coale, Board Member
Charles Dankmeyer, Board Member
Queen Logan Gladden, Board Member
Kenneth Nwafor, Board Member
Leonard “Bud” Schuler, Jr., Board Member
Massachusetts
Commonwealth of Massachusetts—http://www.mass.gov/
Department of Industrial Accidents—http://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
Paul V. Buckley, Commissioner
Tim McMahon, Deputy Commissioner
William C. Tattan, Deputy Commissioner
Martine Carroll, Senior Judge
Click here to download free fillable PDF (Portable Document
Format) versions of Massachusetts workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Massachusetts Workers’ Compensation
Advisory Council—http://www.mass.gov/wcac/
600
Washington Street, Seventh Floor
Boston, Massachusetts 02111
(617) 727-4900, ext. 378; Fax: (617) 727-7122
Edmund C. Corcoran, Jr.,
Chairman
Mickey Long, Vice Chairman
Andrew S. Burton, Executive
Director
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
Paul F. Meagher, President
Michigan
State of Michigan—http://www.michigan.gov/
Department of
Labor & Economic Growth—http://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
David
C. Hollister, Director
Workers’ Compensation Agency—http://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
Kevin A. Elsenheimer, Director, (517) 322-1106, Fax: (517) 322-6689,
elsenheimerk@michigan.gov
Jack A. Nolish, Deputy Director, (517)
322-1106, Fax: (517) 322-6689, nolishj@michigan.gov
Sue Bickel, Secretary, (517) 322-1106, Fax:
(517) 322-6689, sbicke@michigan.gov
Click here to download free fillable PDF (Portable Document
Format) versions of Michigan workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Board of Magistrates—http://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
Murray Gorchow, Acting Chairman, (313) 456-3657,
Fax: (313) 456-3651, magorch@michigan.gov
Workers’
Compensation Appellate Commission—http://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
Martha M. Glaser, Chairperson
James J. Kent
Gregory A. Przybylo
Granner S. Ries
Rodger G. Will
Michigan Economic
Development Corporation—http://medc.michigan.org/
300 North Washington Square
Lansing, Michigan 48913
(888) 522-0103, (517) 373-9808
James
C. Epolito, President and Chief Executive Officer
Sanford
“Sandy” Ring, Chief Operating
Officer
Michigan
Business Guide to Workers’ Compensation—http://medc.michigan.org/services/workerscomp/
Compensation Cost Control Service
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 North 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
Minnesota
State of Minnesota—http://www.mn.gov/
Department of Labor and Industry—http://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
Steve Sviggum,
Commissioner
Workers’ Compensation
Division—http://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
Beth Hargarten, Assistant Commissioner
Click here to download free fillable PDF (Portable Document
Format) versions of
Minnesota workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Workers’ Compensation Court of Appeals—http://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
Thomas L. Johnson, Chief Judge
William R. Pederson, Judge
Miriam P. Rykken, Judge
David A. Stofferahn, Judge
Debra A. Wilson, Judge
Mississippi
State of Mississippi—http://www.ms.gov/
Mississippi Workers’ Compensation
Commission—http://www.mwcc.state.ms.us/
Street Address:
1428 Lakeland Drive
Jackson, Mississippi 39216
Mailing Address:
Post Office Box 5300
Jackson, Mississippi 39296-5300
(866) 473-6922, (601) 987-4200, Fraud: (601) 359-4250
Liles
Williams, Chairman, (601) 987-4258, lwilliams@mwcc.state.ms.us
Debra Gibbs, Commissioner, (601) 987-4254, dgibbs@mwcc.state.ms.us
John Junkin, Commissioner, (601) 987-4254, jjunkin@mwcc.state.ms.us
Ray C. Minor, Executive Director, (601) 987-4205, rminor@mwcc.state.ms.us
Phyllis Clark, Commission Secretary, (601) 987-4252, pclark@mwcc.state.ms.us
Missouri
State of Missouri—http://www.mo.gov/
Department of Labor and Industrial Relations—http://www.labor.mo.gov/
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
Lawrence G. Rebman, Director, (573)
751-9691, Fax: (573) 751-4135, E-mail: Diroffice@dolir.mo.gov
- Division of Workers’
Compensation—http://www.labor.mo.gov/DWC/
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
Brian May, Director, (573) 751-4231, Fax: (573) 751-2012
Click here to download free fillable PDF (Portable Document Format) versions of Missouri workers’ compensation forms courtesy Interface Technologies—http://www.interfacetec.com/ - Labor and Industrial
Relations Commission—http://www.labor.mo.gov/LIRC/
Street Address:
3315 West Truman Boulevard
Jefferson City, Missouri 65102
Mailing Address:
Post Office Box 599
Jefferson City, Missouri 65102-0599
(573) 751-2461, Fax: (573) 751-7806, E-Mail: lirc@labor.mo.gov
William F. Ringer, Chairman
Alice A. Bartlett, Commissioner
John J. Hickey, Commissioner
Pamela M. Hofmann, Secretary
Montana
State of Montana—http://mt.gov/
Department of Labor and Industry—http://dli.mt.gov/
Post Office Box 1728
Helena, Montana 59624-1728
(406) 444-2840, Fax: (406) 444-1394
E-mail: dliquestions@mt.gov
Keith Kelley, Commissioner
Employment Relations Division—http://erd.dli.mt.gov/
Street Address:
1805 Prospect Avenue
Helena, MT 59624
Mailing Address:
Post Office 8011
Helena, MT 59604-8011
(406) 444-6543
Jerry Keck, AdministratorWorkers’ Compensation Claims Assistance Bureau—http://erd.dli.mt.gov/wcca-bureau.html
Street Address:
1805 Prospect Avenue
Helena, Montana 59624
Mailing Address:
Post Office Box 8011
Helena, Montana 59624-8011
(406) 444-6543, Fax: (406) 444-3465, TDD: (406) 444-9696
E-mail: jakoehl@mt.gov
Diana Ferriter, Bureau Chief, (406) 444-6543, diferriter@mt.govWorkers’ Compensation Regulations Bureau—http://erd.dli.mt.gov/workers-comp-regulations-bureau.html
Street Address:
1805 Prospect Avenue
Helena, Montana 59624
Mailing Address:
Post Office Box 8011
Helena, Montana 59624-8011
(406) 444-6541, Fax: (406) 444-3465
Connie Ferriter, Acting Bureau Chief, (406) 444-6541Workers’ Compensation Court—http://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
James Jeremiah Shea, Judge
Montana State Fund—http://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
Laurence Hubbard, President/CEO
Montana Self-Insurers Guaranty Fund
5865 Rosendale Road
East Helena, MT 59635-9727
(406) 475-3766,
mtguarantyfund@mt.net
Jeff Lapham,
Executive Director
Nebraska
State of Nebraska—http://www.nebraska.gov/
Workers’ Compensation Court—http://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
Michael K. High, Presiding
Judge
Ronald L. Brown, Judge
Michael P. Cavel, Judge
James K. Coe, Judge
J. Michael Fitzgerald, Judge
John R. Hoffert, Judge
Laurel K. Van Norman, Judge
Glenn W. Morton, Administrator, (402)
471-3602, Fax: (402)
471-2700, glenn.morton@wcc.ne.gov
Nevada
State of Nevada—http://www.nv.gov/
Department of Business & Industry—http://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 Relations—http://dirweb.state.nv.us/
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7260, Fax: (775) 687-6305
D. Roger Bremner, Administrator, (775) 684-7260, Fax: (775) 687-6305, rbremner@dbi.state.nv.us
John Laxalt, Assistant Administrator, (775) 684-7263, Fax: (775) 687-6305, jplaxalt@dbi.state.nv.usIndustrial Insurance Regulation Section—http://dirweb.state.nv.us/iirs.htm
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7270, Fax: (775) 687-6305Workers’ 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
Charles J. Verre, Chief Administrative Officer, (702) 486-9087, cverre@dbi.state.nv.us
Northern District:
400 West King Street, Suite 400
Carson City, Nevada 89703
(775) 684-7270, Fax: (775) 687-6305
Charlotte LaCombe, (775) 684-7278, clacombe@dbi.state.nv.us
Southern District:
1301 North Green Valley Parkway, Suite 200
Henderson, Nevada 89074
(702) 486-9080, Fax: (702) 990-0364
Ken Webb, Manager, (702) 486-9105, kwebb@dbi.state.nv.usNevada Attorney for Injured Workers—http://naiw.nv.gov/
Nancyann Leeder, Nevada Attorney for Injured Workers2200 South Rancho Drive, Suite 230
Las Vegas, Nevada 89102
(702) 486-2830, Fax: (702) 486-2844
E-mail: naiw@naiw.nv.gov
Gary Watson, Supervising Attorney
1000 East William Street, Suite 208
Carson City, Nevada 89701
(775) 684-7555, Fax: (775) 684-7575
E-mail: naiw@naiw.nv.gov
Donna Sweger, Supervising Attorney
EMPLOYERS Insurance—http://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.
Douglas D. Dirks, President
and Chief Executive Officer of Employers Holdings, Inc.
New Hampshire
State of New Hampshire—http://www.nh.gov/
Department of Labor—http://www.labor.state.nh.us/
95 Pleasant Street
Concord,
New Hampshire 03301
(603) 271-3177
George N. Copadis, Commissioner
David M. Wihby, Deputy Commissioner
Workers’ Compensation
Division—http://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)
Kathryn J. Barger, Director, (800)
272-4353,
(603) 271-3176
Click here to download free fillable PDF (Portable Document
Format) versions of New Hampshire workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
New Jersey
State of New Jersey—http://www.nj.gov/
Department of Labor—http://lwd.dol.state.nj.us/labor/
John Fitch Plaza
Post Office Box 110
Trenton, New Jersey 08625
(609) 292-2323, Fax: (609)
633-9271
Harold J. "Hal" Wirths, Commissioner,
(609) 292-2975
Division of Workers’
Compensation—http://lwd.dol.state.nj.us/labor/wc/wc_index.html
Post
Office Box 381
Trenton, New Jersey 08625-0381
(609) 292-2515, Fax: (609) 984-2515
E-mail: dwc@dol.state.nj.us
Peter Calderone,
Chief Judge & Director, (609) 292-2414, fax: (609) 984-2515,
peter.calderone@dol.state.nj.us
Renee Ricciardelli, Administrative Supervising Judge, (609) 292-2414,
fax: (609) 984-2515, renee.ricciardelli@dol.state.nj.us
Click here to download free fillable PDF (Portable
Document Format) versions of New Jersey workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
N.J. Compensation Rating and Inspection
Bureau—http://www.njcrib.com/
60 Park Place
Newark, New
Jersey 07102
(973) 622-6014, Fax: (973) 622-6110
Grover E. Czech, Executive Director, (973) 622-6014, ext. 213
Frederick A. Huber, Associate Executive Director, (973) 622-6014, ext. 223
Roland E. Brazda III, Director, Underwriting, (973) 622-6014, ext. 214
Robert J. Eichler, Director, MIS, (973) 622-6014, ext. 275
Stanley R. Markow, Acting Director, Actuarial, (973) 622-6014, ext. 211
Salvatore A. Nardone, Director, Experience Rating, (973) 622-6014, ext. 216
Janet Nicolai, Director, Human Resources, (973) 622-6014, ext. 221
John T. Skidmore, Director, Policy Review, (973) 622-6014, ext. 217
Paul G. Witko, Director and Special Assistant to the Executive Director, (973) 622-6014, ext. 215
New Mexico
State of New Mexico—http://www.newmexico.gov/
Workers’ Compensation Administration—http://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
Glenn
R. Smith, Director, (505) 841-6007
Abelino
Montoya, Jr., Assistant Director
Al Otero, Special Assistant to the Director
Chris Johnston, Facilities Management
Ida Alvarado, Financial Services
Van Cravens, Public Information Officer, (505) 841-6004,
Van.Cravens@state.nm.us
Greg Griego, Dispute Resolution
Sharon Gentry, Office of the General Counsel
Christopher Marlowe, Enforcement
Laura Feight, Deputy Director, Internal
Operations Division
Elaine Trujillo, Deputy Director, External
Operations Division
Workers’ Compensation Judges
Gregory
D. Griego, Judge, (505) 841-6023
Terry Kramer, Judge, (505) 841-6029
Victor S. Lopez, Judge, (505) 841-6014
Juanita Roibal-Bradley, Judge Pro Tem, (505) 841-6029
Helen L. Stirling, Judge, (505) 841-6841
Advisory Council on Workers’ Compensation and Occupational
Disease Disablement
Nick Kapnison, Chairman, Business Member, (505)
872-1700
Mike Anaya, Business Member, (505) 832-4715 or
832-4391
Emily Kane, Labor Member, (505) 841-6000
Mark G. Henderson, Business Member, (505) 292-8955
Jude McMullen, Labor Member, (505) 841-6000
Fidel A. Munoz, Labor Member, (505) 265-7933
Glenn R. Smith, Ex-Officio Member, (505) 841-6007
New York
State of New York—http://www.ny.gov/
New York State Workers’ Compensation Board—http://www.wcb.ny.gov/
20 Park Street
Albany, New York 12207
(877) 632-4996, (518) 462-8880,
Fax: (518) 473-1415, Claims Fax: (877) 533-0337, Fraud: (888) 363-6001
E-mail:
general_information@wcb.ny.gov
Robert E. Beloten, Chair
Frances M. Libous, RN, BS, Vice Chair
Mona A. Bargnesi, Member
Richard A. Bell, Member
David Dudley, Member
Donna Ferrara, Member
Candace K. Finnegan, Member
Freida Foster, Member
Mark D. Higgins, Member
Loren Lobban, Member
Conrad W. Lower, Member
Ellen O. Paprocki, Member
Samuel G. Williams, Member
Jeffrey Fenster, Executive Director
Advocate for Business, (800) 628-3331
Edwin Ruff, Advocate for Injured Workers, (800) 580-6665, (518) 474-8182,
Fax: (518) 486-7510
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 Fund—http://ww3.nysif.com/
199 Church Street
New York, New York 10007
(888) 875-5790, (212) 312-9000, Fax: (212) 385-2073
Donald T. DeCarlo, Chairman
H. Sidney Holmes III, Vice Chairman
Mario Cilento, Member
Eileen A. Frank, Member
Robert H. Hurlbut, Member
David E. Ourlicht, Member
Kenneth R. Theobalds, Member
Colleen Crawford Gardner, Ex-Officio Member
Dennis J. Hayes, Chief Executive Deputy Director
North Carolina
State of North Carolina—http://www.ncgov.com/
Department of Commerce—http://www.nccommerce.com/
Mailing Address:
4301 Mail Service Center
Raleigh, North Carolina 27699-4301
Street Address:
301 North Wilmington Street
Raleigh, NC 27601-1058
(919) 733-4151
E-mail: info@nccommerce.com
Sharon Allred Decker, Secretary
North Carolina Industrial Commission—http://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 or (919) 807-2501. Fax: (919) 715-0280.
Help Line: (800) 688-8349, (919) 807-2501, or InfoSpec@ic.nc.gov.
Fraud and Insurance Compliance Hotline: (888) 891-4895 or fraudcomplaints@ic.nc.gov.
Safety Education: (919) 807-2603 or safety@ic.nc.gov
Staci T. Meyer, Chair, (919) 807-2525, Staci.Meyer@ic.nc.gov
Bernadine S. Ballance, Commissioner, (919) 807-2511, Bernadine.Ballance@ic.nc.gov
Linda Cheatham, Commissioner, (919) 807-2523, Linda.Cheatham@ic.nc.gov
Danny Lee McDonald, Commissioner, (919) 807-2516, Danny.McDonald@ic.nc.gov
Tammy R. Nance, Commissioner, (919) 807-2521, Tammy.Nance@ic.nc.gov
Pamela T. Young, Commissioner, (919) 807-2517, Pamela.Young@ic.nc.gov
Administrator, (919) 807-2507.
Workers’ Compensation Information Specialists Section (formerly Ombudsman Section):
http://www.ic.nc.gov/infospec.html.
Contact Information Specialists: (800) 688-8349 or InfoSpec@ic.nc.gov.
Fraud Investigations Section: http://www.ic.nc.gov/fraud.html.
Contact Fraud Investigations: (888) 891-4895 or fraudcomplaints@ic.nc.gov.
Safety Education Section: http://www.ic.nc.gov/safety.html.
Contact Safety Education: (919) 807-2603 or safety@ic.nc.gov.
Click here to download free fillable PDF (Portable Document Format) versions of North Carolina workers’ compensation forms courtesy Interface Technologies—http://www.interfacetec.com/
North Dakota
State of North Dakota—http://www.nd.gov/
Workforce Safety & Insurance—http://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
Brent J. Edison, Executive Director/CEO
Workforce Safety & Insurance Board of Directors
Post Office Box 2174
Bismarck, North Dakota 58502-2174
David H. Ystebo, Chairman
Robert M. Indvik, Vice Chairman
Richard Bergstad
Mark Gjovig
Sindy Keller
Cal Kolling
Evan Mandigo
Robert Nelson
Denny Schneider
Nancy A. Slotten
Allen “Gene” Wyman, M.D.
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
Marsha
P. Ryan, Administrator
Click here to download free fillable PDF (Portable Document
Format) versions of Ohio workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Industrial Commission of Ohio—http://www.ohioic.com/index.jsp
30 West Spring Street
Columbus, Ohio 43215-2256
(800) 521-2691, (614) 466-6136, Fax: (614) 752-8304
William E. Thompson, Chairman
Patrick J. Gannon, Member
Barbara Knapic, Member
Oklahoma
State of Oklahoma—http://www.ok.gov/
Oklahoma
Workers’
Compensation Court—http://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)
Mary A. Black,
Presiding Judge
Tom Leonard, Vice Presiding Judge
Richard L. Blanchard, Judge
Ellen C. Edwards, Judge
Kenton W. Fulton, Judge
Gene Prigmore, Judge
Cherri Farrar, Judge
Michael J. Harkey, Judge
John M. McCormick, Judge
Kent Eldridge, Judge
Marcia Davis, Administrator, (405)
522-8776
Mike Sykes, Supervisor, Counselors Department, (405)
522-8760 or (800) 522-8210 (statewide)
Department of Labor—http://www.okdol.state.ok.us/
4001 North Lincoln Boulevard
Oklahoma City, Oklahoma 73105-5212
(888) 269-5353, (405)
528-1500 Fax: (405) 528-5751
Lloyd L. Fields, Commissioner, (405)
528-1500, ext. 200; Fax: (405) 528-5751;
lfields@oklaosf.state.ok.us
Workers’ Compensation
Enforcement Unit—http://www.okdol.state.ok.us/workcomp/index.htm
Sharon Eischen, Director, seischen@oklaosf.state.ok.us
Worker Safety Policy
Council—http://www.okdol.state.ok.us/wspc/index.htm
Lloyd L. Fields, Chairman
Clayton Abernathy,
Member
Scott Barger,
Member
Jim Bowien, Member
Harry Coates,
Member
Steve Compton,
Member
Cheryl Dorrance,
Member
Debbe Leftwich,
Member
Cheryl Marcham,
Member
Chuck Mills,
Member
Gerri Mooney,
Member
Norma Noble,
Member
Robert Noll, Member
Don Powers, Member
Dave Koeneke, Member
Mike Seney, Member
Mike Wilt, Member
Trebor Worthen, Member
CompSource Oklahoma—http://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
Terry
McCullar, President and Chief Executive Officer, (405) 962-3334,
Fax: (405) 962-3127
Janet McFeeters,
Assistant to the President, (405) 962-3262, Fax: (405) 962-3127,
janet_m@compsourceok.com
Davina Craig-Sealock,
Executive Secretary, (405) 962-3294, Fax: (405) 962-3127,
davina_c@compsourceok.com
Lisa
Blodgett, General Counsel,
(405) 962-3811, Fax: (405) 962-3048,
lisa_b@compsourceok.com
Board of Managers:
Tom
Jaworsky, Chair
Tony Hutchison,
Vice Chair
Ron Brown, Secretary
Lt. Gov. Jari Askins,
Member
David Atkinson,
Member
Andy Bass, Member
Betty Cairns, Member
Clay Curtis, Member
Pat Malloy,
Member
Oregon
State of Oregon—http://www.oregon.gov/
Department of Consumer & Business
Services—http://egov.oregon.gov/DCBS/
350 Winter Street NE
Salem, Oregon 97301-3878
(503) 378-4100, Fax: (503) 378-6444
Cory Streisinger, Director, (503) 378-4100,
DCBS.Director@state.or.us
Greg Malkasian, Deputy Director, (503)
378-4100, Fax: (503) 378-6444,
Gregory.A.Malkasian@state.or.us
Workers’ Compensation Division—http://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
John L. Shilts, Administrator,
(503) 947-7500, Fax: (503) 947-7514, John.L.Shilts@state.or.us
Jerry Managhan, Deputy Administrator, (503)
947-7501, managhjr@cbs.state.or.us
Workers’
Compensation Board—http://www.cbs.state.or.us/external/wcb/index.html
2601 25th
Street SE, Suite 150
Salem, Oregon 97302-1282
(503) 378-3308
Maureen Bock, Chairman
Frank J. Biehl, Member
Mustafa Kasubhai, Member
Greig Lowell, Member
Vera Langer, Member
Workers’
Compensation Management-Labor Advisory Committee—http://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
Labor Representatives:
Bob Shiprack, Co-Chair, Oregon Building Trades Council
Lon Holston, AFSCME
John Kirkpatrick, IUPAT District Council #5
Mike O’Rourke, Plumbing & Steamfitters UA 290
Brad Witt, Oregon AFL-CIO
Management Representatives:
J. L. Wilson, Co-Chair, NFIB/Oregon
Ken Hector, CNF Service Company
Diane Janzen, NorPac
Sheri Sundstrom, Hoffman Construction Company of Oregon
Lisa Trussell, Associated Oregon Industries
Lou Savage, Administrator, (503) 378-4100,
louis.d.savage@state.or.us
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
Maria A. Carraher, Ombudsman for
Injured Workers Maria.A.Carraher@state.or.us
Ombudsman for
Small Business—http://egov.oregon.gov/DCBS/SBO/index.shtml
350 Winter Street
NE
Salem, Oregon 97301-3878
(503) 378-4209, V/TTY: (503) 378-4100
John
R. Booton, Small Business Ombudsman John.R.Booton@state.or.us
SAIF Corporation—http://www.saif.com/
400 High Street
SE
Salem, Oregon 97312-1000
(800) 285-8525, (503)
373-8000
Cecil W. Tibbetts, Acting President and
Chief Executive Officer
Jon A. Egge, Chair, Board of Directors
Pennsylvania
State of Pennsylvania—http://www.pa.gov/portal/server.pt
State
Workers’ Insurance Fund—http://www.dli.state.pa.us/landi/cwp/view.asp?a=151&q=209835
Workers’ Compensation Appeal Board--http://www.dli.state.pa.us/landi/cwp/view.asp?a=296&q=202912
State of Rhode Island—http://www.state.ri.us/
Medical
Advisory Board—http://www.courts.ri.gov/workers/medical/medical-advisory.htm Department of Labor and Training—http://www.dlt.ri.gov/
State of South Carolina—http://www.sc.gov/ South Carolina State Accident Fund—http://www.saf.sc.gov/
South Carolina Second Injury Fund—http://www.scsif.sc.gov/ South Carolina Self-Insurers Association—http://www.scselfinsurers.com/ State of South Dakota—http://www.sd.gov/
State of Tennessee—http://www.tennessee.gov/
Current workers' compensation forms may be found at http://www.tn.gov/labor-wfd/mainforms.shtml.
State of Texas—http://www.texas.gov/
State of Utah—http://www.utah.gov/ Workers’ Compensation
Fund—https://www.wcfgroup.com/wcfWebsite/homePage.do State of Vermont—http://vermont.gov/
Workers’ Compensation & Safety Division—http://labor.vermont.gov/Business/WorkersCompensation/tabid/114/Default.aspx
Commonwealth of Virginia—http://www.virginia.gov/
State of Washington—http://access.wa.gov/
Board of Industrial Insurance Appeals—http://www.biia.wa.gov/
West Virginia—http://www.wv.gov/ Workers’ Compensation Office of Judges—http://www.wvinsurance.gov/ooj/ Workers’
Compensation Board of Review—http://www.wvinsurance.gov/boardofreview/index.htm Workers’ Compensation Industrial Council—http://www.wvinsurance.gov/WorkersCompensation/IndustrialCouncil.aspx
State of Wisconsin—http://www.wisconsin.gov/state/home Workers’ Compensation
Advisory Council—http://www.dwd.state.wi.us/wc/councils/wcac/default.htm
Wisconsin
Compensation Rating Bureau—https://www.wcrb.org/WCRB/wcrbhome.htm Wisconsin Labor and Industry
Review Commission—http://www.dwd.state.wi.us/lirc/
State of Wyoming—http://wyoming.gov/
Workers’ Safety and Compensation Division—http://wydoe.state.wy.us/doe.asp?ID=9 Employment Tax Division—http://wydoe.state.wy.us/doe.asp?ID=10 American Samoa—http://www.government.as/
Government of Guam—http://www.guam.gov/
Navajo Nation—http://www.navajo.org/
Commonwealth of the Northern Mariana Islands—http://www.gov.mp/
Puerto Rico—http://www.gobierno.pr/ State Insurance Fund
Virgin Islands—http://www.usvi.org/
Government of Canada—http://canada.gc.ca/ Government of Alberta—http://www.gov.ab.ca/index2.html Government of British Columbia—http://www.gov.bc.ca/ Government of Manitoba—http://www.gov.mb.ca/ Government of New Brunswick—http://www.gov.nb.ca/ Government of Newfoundland—http://www.gov.nf.ca/ Government of the Northwest Territories
—http://www.gov.nt.ca/ Government of Nova Scotia—http://www.gov.ns.ca/ Government of Ontario—http://www.gov.on.ca/ Government of Prince Edward Island—http://www.gov.pe.ca/ Province of Québec—http://www.gouv.qc.ca/ Government of Saskatchewan—http://www.gov.sk.ca/ Government of Yukon—http://www.gov.yk.ca/
Department of Labor and Industry—http://www.dli.state.pa.us/
Labor & Industry Building
Room 1700
7th and Forster Streets
Harrisburg, Pennsylvania 17120
(717) 787-5279
Sandi Vito, Acting Secretary
Bureau of Workers’ Compensation—http://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
John T. “Jack” Kupchinsky, Director,
jkupchinsk@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/
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
Marisue
Newman, Director
1171 South Cameron Street, Room 305
Harrisburg, Pennsylvania 17104-2511
(717) 783-7838, Fax: (717)
772-0343
Susan M. McDermott, Chairman
Robert E. Giles, Secretary
William R. Davis, Commissioner
Harold V. Fergus, Jr., Commissioner
Daniel R. Fleck, Commissioner
Alfonso Frioni, Jr., Commissioner
Herbert W. Hoffman, Commissioner
Robert A. Krebs, Commissioner
Robert T. McIntyre, Commissioner
Gail L. O’Neal, Commissioner
Joseph T. Rafferty, Commissioner
Joseph P. Santone, Commissioner
John J. Schmitt, Commissioner
Harry Schwartz, Commissioner
Delores Wilson, Commissioner
Rhode Island
Workers’ Compensation Court—http://www.courts.state.ri.us/workers/defaultnew-workers.htm
One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-5000, Fax:
(401) 222-3121
George E. Healy, Jr.,
ghealy@courts.state.ri.us
Jannette
A. Bertness, Judge, jbertness@courts.state.ri.us
Dianne M. Connor, Judge,
dconnor@courts.state.ri.us
Bruce Q. Morin, Judge,
bmorin@courts.state.ri.us
Debra L. Olsson, Judge,
dolsson@courts.state.ri.us
Hugo L. Ricci, Jr., Judge,
hricci@courts.state.ri.us
John
Rotondi, Jr., Judge, jrotondi@courts.state.ri.us
George T. Salem, Jr., Judge,
gsalem@courts.state.ri.us
Edward P. Sowa, Jr., Judge,
esowa@courts.state.ri.us
Dennis I. Revens, Administrator, drevens@courts.state.ri.us
Kenneth D. Haupt, Deputy Administrator, khaupt@courts.state.ri.us
One Dorrance Plaza
Providence, Rhode Island 02903
(401) 458-3460
Vincent J. Yakavonis, MD,
Chair
Maureen Aveno, Administrator,
MAveno@courts.state.ri.us
Workers’ Compensation Advisory Council
194 Smith Street
Providence, Rhode Island 02908
(401) 751-7100
George Nee, Chairperson
1511 Pontiac Avenue
Cranston, Rhode Island 02920-4407
(401) 462-8000
Adelita S. Orefice, Director, AOrefice@DLT.state.ri.us
Workers’ Compensation Division—http://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
E. Jean Severance, Associate Director, (401)
462-8081, JSeverance@DLT.state.ri.us
Matthew P. Carey, III, Assistant Director, (401)
462-8127, MCarey@DLT.state.ri.us
Click here to download free fillable PDF (Portable Document
Format) versions of Rhode Island workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
South Carolina
Workers’ Compensation Commission—http://www.wcc.sc.gov/
Street Address:
1333 Main Street
Columbia, South Carolina 29202
Mailing Address:
Post Office Box 1715
Columbia, South Carolina 29202-1715
(803) 737-5700, Fax: (803) 737-5768
T. Scott Beck, Interim Chairman, (803) 737-5700, Fax: (803) 737-1208
Susan S. Barden, Vice Chair, (803) 737-5700, Fax: (803) 737-1205
Melody James, Commissioner, (803) 737-5700, Fax: (803) 737-1206
Gene McCaskill, Commissioner, (803) 737-5700, Fax: (803) 737-1209
Andrea C. Roche, Commissioner, (803) 737-5700, Fax: (803) 737-1204
Aisha Taylor , Commissioner, (803) 737-5700, Fax: (803) 737-1212
Avery B. Wilkerson, Jr., Commissioner, (803) 737-5700, Fax: (803) 737-1207
Gary M. Cannon, Executive Director, (803) 737-5744, Fax: (803) 737-5764, gcannon@wcc.sc.gov
Click here to download free fillable PDF (Portable Document
Format) versions of South Carolina workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Street Address:
800 Dutch Square Boulevard, Suite 160
Columbia, South Carolina 29210-7317
Mailing Address:
Post Office Box 102100
Columbia, South Carolina 29221-5000
(800) 521-6576, (803) 896-5800
Harry B. Gregory, Jr., Director
100 Executive Center Drive
Santee Building, Suite 101
Columbia, South Carolina 29210
(803) 798-2722, Fax: (803) 798-5290
E-mail: dmannin@sif.state.sc.us
William E. Gunn, Director
Michael T. Harris, Deputy Director
Debbie Manning, Administrative Manager
Pete Calamas, Director of Claims
Ann P. Corley, Director of Recoveries
Latonya D. Edwards, General Counsel
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
215 Holly Ridge Lane
West Columbia, SC 29169
(803) 794-2080, Fax: (803) 939-8366
Mobashir “Moby” Salahuddin, Executive Director, msalahuddin@sc.rr.com
Board of Directors
Tosca Walls, President
Brian J. Teusink, CPA, CCM, AIAF, Vice President
John Mellette, ARM, CSP, Secretary
David Benenhaley
Mike Chase, Legal Advisor
Ted Contos, Board Member
Joseph H. Hutchinson, Board Member
Jerry L. Johnson, ARM, AIC, Board Member
David Hill Keller, Board Member
Linda Maass, Board Member
Hugh McAngus, Board Member
Heather Ricard, CPA, Board Member
Jarrett Robinson, Board Member
M. Clifton Scott, Board Member
Chip Timmons, Board MemberSouth Dakota
Department of Labor—http://dol.sd.gov/
Pamela S. Roberts, Secretary of Labor
Workers’ Compensation
Program—http://dol.sd.gov/workerscomp/default.aspx
Kneip
Building
700 Governors Drive
Pierre, South Dakota 57501-2291
(605) 773-3681, Fax: (605) 773-4211
E-mail: labor@dol-pr.state.sd.us
James Marsh, Director
Workers’ Compensation Advisory Council—http://dol.sd.gov/workerscomp/advisorycouncil.aspx
Dennis Daugaard, ChairTennessee
Department of Labor and Workforce Development—http://www.tennessee.gov/labor-wfd/
Workers’ Compensation
Division—http://www.state.tn.us/labor-wfd/wcomp.html
220 French Landing Drive
First Floor, Side B
Nashville, Tennessee 37243-1002
(800) 332-2667 (within Tennessee), (615) 532-4812, Fax: (615) 532-1468
E-mail: wc.info@tn.gov
Abbie Hudgens, Administrator
Jeff Francis, Assistant Administrator
Click here to download free fillable PDF (Portable Document
Format) versions of Tennessee workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/Texas
Department of Insurance—http://www.tdi.texas.gov/
Street Address
333 Guadalupe
Austin, Texas 78701
Mailing Address
Post Office Box 149104
Austin, Texas 78714-9104
(800) 252-3439, (512) 463-6169
Eleanor Kitzman, Commissioner, (512) 463-6464, Fax: (512) 475-2005
Division
of Workers’ Compensation—http://www.tdi.texas.gov/wc/indexwc.html
7551
Metro Center Drive, Suite 100
Austin, Texas 78744-1609
Main number: (800) 372-7713, (512) 804-4000, E-Mail:
WorkersCompCustomerServices@tdi.texas.gov. Other Contacts:
http://www.tdi.texas.gov/wc/dwccontacts.html
Rod Bordelon, Commissioner of Workers’ Compensation
Click here to download free fillable PDF (Portable Document Format)
versions of Texas workers’ compensation forms:
http://www.tdi.texas.gov/forms/form20all.html.
Utah
Labor Commission—http://www.laborcommission.utah.gov/
Sherrie M. Hayashi, Commissioner
Division of
Industrial Accidents—http://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
R. Lee Ellertson,
Chairman
Thomas R. Carlson, Commissioner
Colleen S. Colton, Commissioner
Larry D. Bunkall, Director, (801)
530-6988, Fax: (801) 530-6804,
lbunkall@utah.gov
Salt Lake City Office
392 East 6400 South
Murray, Utah 84107
(800) 446-2667
Ray Pickup, President and Chief Executive Officer,
(801) 288-8000
Board of Directors
Robert D. Myrick, Chair
Judd A. Turner , Vice Chair
Dallas H. Bradford
Roger Livingston
Ruth Lybbert
Robert B. Murray
Lane A. SummerhaysVermont
Department of Labor—http://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
Patricia A. McDonald,
Commissioner, (802) 828-4000,
pmcdonald@labor.state.vt.us
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
J. Stephen Monahan, Director, (802) 828-2138,
stephen.monahan@state.vt.us
Rebecca Smith, Staff Attorney, (802) 828-2992,
rebecca.smith@state.vt.us
Kristina Bielenberg, Supervisor, (802) 828-2286,
kristina.bielenberg@labor.state.vt.us
Click here to download free fillable PDF (Portable Document
Format) versions of Vermont workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Virginia
Virginia Workers’ Compensation Commission—http://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
Lawrence D. Tarr, Chairman, (804) 367-8666
Virginia R. Diamond, Commissioner, (804) 367-8657
William L. Dudley, Jr., Commissioner, (804) 367-8659
James J. Szablewicz, Chief Deputy Commissioner, (804)
367-8664
Kim
Harris, Manager, Human Resources Department, (804) 367-8637
Edward P. Rice,
Comptroller, (804) 367-0580
R. Temple Mayo,
Director of Claims/Deputy Commissioner, (804) 367-8625
Eileen Mundok,
Chief Information Officer,
(877) 664-2566
Click here to download free fillable PDF (Portable Document Format)
versions of Virginia workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
Washington
Department of Labor and Industries—http://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
Judy Schurke, Director
Workers’ Comp
Claims—http://www.lni.wa.gov/ClaimsIns/Claims/default.asp
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
Thomas
E. Egan, Chairman and Public Member
Frank E. Fennerty,
Jr., Labor Member
Calhoun Dickinson,
Employer Member
Click here to download free fillable PDF (Portable Document Format)
versions of Washington workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
West Virginia
Insurance Commission—http://www.wvinsurance.gov/
Michael D. Riley, Commissioner
Workers’ Compensation Insurance Division—
http://www.wvinsurance.gov/WorkersCompensation.aspx
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
Rebecca A. Roush, Chief Administrative Law Judge
Mailing
Address:
Post Office Box 2628
Charleston, West Virginia 25329-2628
Street Address:
1207 Quarrier Street, Suite 304
Charleston, West Virginia 25301
(304) 558-5230, Fax: (304) 558-1322
James D. Gray, Chair
Rita Hedrick-Helmick, Member
W. Jack Stevens, Member
Voting Members:
Kenneth William "Bill" Dean, Chairman
Dan Marshall, Co-Chairman
Edward Kent Hartsog, Co-Chairman
James H. Dissen
Legislative Members:
Brooks F. McCabe, Jr.
Nancy Peoples Guthrie
Insurance Commissioner:
Michael D. RileyWisconsin
Department of Workforce Development—http://www.dwd.state.wi.us/
Workers’ Compensation
Division—http://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
Frances
Huntley-Cooper, Administrator, (608) 266-6841, frances.huntley-cooper@dwd.state.wi.us
John Conway, Deputy Administrator, (608)
266-0337, conwajo@dwd.state.wi.us
Jean Culbert, Administrative Support,
(608) 266-6898, culbeje@dwd.state.wi.us
Click here to download free fillable PDF (Portable Document Format)
versions of Wisconsin workers’
compensation forms courtesy Interface
Technologies—http://www.interfacetec.com/
(608) 266-6841
Frances
Huntley-Cooper,
Chairman
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
Ralph M. Herrmann, President, herrmra@dwd.state.wi.us
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
David B. Falstad, Chairman
Laurie R. McCallum, Commissioner
James A. Rutkowski, Commissioner
James L. Pflasterer, General Counsel
Wyoming
Department of Employment—http://wydoe.state.wy.us/
Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, Wyoming 82002
(307) 777-7672, Fax: (307) 777-5805
Gary
W. Child, Director, (307) 777-5960,
GCHILD@STATE.WY.US
Charles Rando, Administrator, (307) 777-6370,
CRANDO@state.wy.us
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.
Steve
Czoscke, Administrator, (307) 777-5110, Fax: (307) 777-5524,
SCZOSC@STATE.WY.US
Post Office Box 2760
Casper, Wyoming 82602-2760
(307) 235-3201 (Casper) or (307) 777-7471 (Cheyenne)
Wendy Tyson, Administrator, (307) 777-6763,
wtyson@state.wy.us
Other U.S. Areas
American Samoa
Workmen’s Compensation
Commission
Office of the Governor
Pago Pago, American Samoa 96799
(684) 633-4116
Moaali’itele Tu’ufuli, Commissioner
Tasi Mauga, Administrator
Guam
Department of Labor/Agency for Human
Resources Development—http://www.dol.guam.gov/
Maria S. Connelley, Director of Labor
Workers’ Compensation Commission—http://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
Maria S. Connelley, Commissioner
Mary
Guerrero, Commissioner
Elizabeth Hanzsek, Commissioner
Dr. Gregory J. Miller, Commissioner
Franklin
Taitague, Commissioner
Joannalynn Fullerton,
Acting Administrator,
fullertonjoannalynn@yahoo.comNavajo Nation
Workers’ Compensation Program
Post Office Box 2489
Window Rock, Arizona 86515
(928) 871-6389, Fax: (928) 871-6087
Charlene
B. Chapman, Director, cchapman@nnisd.com
or charchapman@navajo.org
Northern Mariana Islands
Caller Box 10,007
Saipan, MP 96950
USA
(670) 664-2200
Puerto Rico
Comisión
Industrial de Puerto Rico—http://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
Lucy Navarro Rosado, President
Nilda Diaz Olazagasti, Commissioner
Carmen M. Llull Vera, Commissioner
Post Office Box 5028
San Juan, Puerto Rico 00936
Zoimee Alvarez Rubio, Administrator
Virgin Islands
Department of Labor—http://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
Cecil R. Benjamin, Commissioner
Workers’ Compensation Administration—http://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
Idona
Byron, Acting Director
Canada
Federal Jurisdiction
Labour Program
Human Resources Development
Canada—http://labour-travail.hrdc-drhc.gc.ca/
Human Resources
Development Canada
11 Prince of Wales Drive
Ottawa, Ontario K2C 3T2
(800) 463-2493 (in Canada), (416) 954-5900 (Metro Toronto
Area), (519) 645-4424 (London Area) Alberta
Department of Labour—http://www.gov.ab.ca/~lab/
9940 - 106 Street
Edmonton, Alberta
T5K 2N2
(403) 427-8848, (403) 297-2222 (Calgary)
Workers’ Compensation Board-Alberta—http://www.wcb.ab.ca/
Box 2415, 9912 - 107 Street
Edmonton,
Alberta~ T5J 2S5
(403) 498-4000, (403) 498-4950 (Government
Relations Office-Edmonton), Fax: (403) 422-2889 TTY: (403)
422-2716
E-mail: geninfo.wcb.ab@ibm.net
Rick LeLacheur, Chairman of the Board of
DirectorsBritish Columbia
Workers’
Compensation Board of British Columbia—http://www.worksafebc.com/
6951 Westminster Highway
Post Office Box 5350 STN Terminal
Richmond,
British Columbia V6B 5L5
(800) 661-2112 (in British Columbia only),
(604) 273-2266, (604) 273-7711 (after hours safety and health
emergency reporting) Fax: (604) 276-3151
Manitoba
Department of Labour
Workplace Safety and Health
Division—http://www.gov.mb.ca/labour/safety/index.html
200 -
401 York Avenue
Winnipeg, Manitoba R3C 0P8
(800) 282-8069,
(204) 945-3446 Fax: (204) 945-4556
Workers’ Compensation Board of Manitoba—http://www.wcb.mb.ca/
E-mail: wcb@wcb.mb.ca New Brunswick
New Brunswick Workplace Health,
Safety and Compensation Commission—http://www.gov.nb.ca/whscc/index.htm
1 Portland Street
Post
Office Box 160
Saint John, New Brunswick E2L 3X9
(800) 222-9775
(in New Brunswick only), (506) 632-2200 Fax: (506) 738-4229 Newfoundland and Labrador
Department
of Environment and Labour—http://www.gov.nf.ca/env
Occupational
Health and Safety Division
Confederation Building, 4th Floor, West Block
Post Office Box 8700
St John’s, Newfoundland A1B 4J6
(800)
563-5471 (in Newfoundland only), (709) 729-1932 Fax: (709)
729-6639
Workers’ Compensation
Commission of Newfoundland and Labrador—http://www.wcb.nf.ca/ Northwest Territories
Northwest Territories Workers’ Compensation
Board
Post Office Box 8888
Yellowknife, Northwest Territories X1A 2R3
(800) 661-0792 (in North America), (867) 920-3888 Fax:
(867) 873-4596 Nova Scotia
Occupational Health & Safety Division
Department of Labour
5151 Terminal Road, 6th floor
Post Office Box
697
Halifax, Nova Scotia B3J 2T8
(800) 9-LABOUR or (800)
952-2687 (in Nova Scotia only), (902) 424-5400 Fax: (902)
424-3239
Workers’ Compensation Board of Nova Scotia—http://www.wcb.ns.ca/ Ontario
Occupational Health & Safety
Branch—http://www.gov.on.ca/LAB/ohs/ohse.htm
Ministry of Labour —http://www.gov.on.ca/LAB/
400 University Avenue, 8th Floor
Toronto, Ontario M7A 1T7
(800) 268-8013 (in Ontario only),
(416) 326-7770 Fax: (416) 326-7761
Workplace Safety &
Insurance Board (formerly Workers’ Compensation Board)—http://www.wcb.on.ca/wcb/wcb.nsf/public/homepage (new site available
soon: http://www.wsib.on.ca)
200 Front Street West
Toronto,
Ontario
800) 387-5540, (416) 344-1000 Fax: (416)
344-4684 TTY: (800) 387-0050
E-mail: wsibcomm@wsib.on.ca
Workplace Safety and Insurance Appeals
Tribunal—http://www.wcat.on.ca/engindex.htm
505 University
Avenue, 7th Floor
Toronto, Ontario M5G 1X4
(416) 598-4638 Fax:
(416) 326-5164
Ian Strachan, Chairman
Occupational Health and Safety Branch
Ministry of Labour—http://www.gov.on.ca/LAB/ohs/
400 University Avenue, 8th Floor
Toronto, Ontario M7A 1T7
(800) 268-8013 (in Ontario only),
(416) 326-7770 Fax: (416) 326-7761 Prince Edward Island
Occupational Health and Safety Division
Workers’ Compensation Commission
P.O. Box 757
Charlottetown, Prince
Edward Island C1A 7L7
(800) 237-5049 (in Prince Edward Island only),
(902) 368-5680 Fax: (902) 368-5696Québec
Commission de
la santé et de la sécurité du travail du Québec—http://www.csst.qc.ca/
(Occupational Health and Safety Commission)
C P 6056, Succursale Centre-ville
Montréal, Québec H3C 4E1
(800)
667-7585 (in Québec only), (514) 864-9362 Fax: (514) 864-9214Saskatchewan
Department of Labour—http://www.gov.sk.ca/govt/labour/
Occupational Health and Safety
Division
1870 Albert Street
Regina, Saskatchewan S4P 3V7
(800)
567-7233, (306) 787-4496 Fax: (306) 787-2208 ~ Saskatoon
Office: (306) 933-5042; 1-800-667-5051 FAX: (306) 933-7339Yukon Territory
Workers’ Compensation, Health and Safety Board
Occupational Health and Safety Branch
401 Strickland Street
Whitehorse, Yukon Territory Y1A 5N8
(800) 661-0443, (867)
667-5450 Fax: (867) 393-6279