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VWC Forms & Documents

Forms Used in Processing Claims

Subpoena Information and Forms

Employers' Insurance Monitoring Forms

Self-Insurance Forms

Taxation Forms

Petition Under Virginia Birth-Related Neurological Injury Act

Other

Publications from the Commission are available electronically. Forms not available in electronic format may be purchased by filling out the order form below:

Pre-10/1/2008 Forms

Accidents that occur on or after 10/1/08 must be reported to VWC electronically via EDI. For more information about EDI, click here. For accidents that occur before 10/1/08, including minor accidents (formerly reported on Form 45A), use the following form:

Other Pre-10/1/2008 Forms

NOTE: Some of these forms must be submitted on paper of a specific color. Where a specific color is required, the Commission will not accept a form printed on different color paper. If a color other than white is required, the required paper color is given to the right of the name of each form. The paper specified is Hammermill paper.

Commonwealth of Virginia | Governor