FYI: Workers' Comp instructions and information are located at the Benefits Tab, Workers' Compensation
ALL STATES EXCEPT CALIFORNIA AND OHIO:
WC AUTHORIZATION TO TREAT FORM, ALL STATES EXCEPT CALIFORNIA AND OHIO, CONCENTRA
CALIFORNIA ONLY
WC AUTHORIZATION TO TREAT FORM, CALIFORNIA ONLY, CONCENTRA
OHIO ONLY
80028128 OHIO WORKERS' COMPENSATION BUREAU (OHIO ONLY)