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Florida Workers’ Compensation

Helpful Documents

The documents referenced on this page come from the State of Florida’s Workers’ Compensation website. The Florida Workers’ Compensation law firm of Kevin Moore has put links to these documents on this site to make it easier for you to get all of the information you need to understand your case and the law. For specific questions and help, Contact the Firm for a free consultation.

FIRST REPORT OF INJURY OR ILLNESS
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

First Report of Injury or Illness (DFS-F2-DWC-1)


WAGE STATEMENT
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Wage Statement (DFS-F2-DWC-1a)


REQUEST FOR WAGE LOSS/TEMPORARY PARTIAL BENEFITS
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Request for Wage Loss/Temporary Partial Benefits (DFS-F2-DWC-3)


Information Management
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Notice of Action/Change (DFS-F2-DWC-4 )


NOTICE OF DENIAL
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Notice of Denial (DFS-F2-DWC-12 )


CLAIM COST REPORT
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Claim Cost Report (DFS-F2-DWC-13 )


REQUEST FOR SOCIAL SECURITY DISABILITY BENEFIT INFORMATION
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Request for Social Security Disability Benefit Information (DFS-F2-DWC-14)


EMPLOYEE EARNINGS REPORT
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Employee Earnings Report (DFS-F2-DWC-19)


AUTHORIZATION AND REQUEST FOR UNEMPLOYMENT COMPENSATION INFORMATION
AGENCY FOR WORKFORCE INNOVATION
FLORIDA DEPARTMENT OF FINANCIAL SERVICES

Authorization and Request for Unemployment Compensation Information (DFS-F2-DWC-30)


PERMANENT TOTAL OFF-SET WORKSHEET
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Permanent Total Off-Set Worksheet (DFS-F2-DWC-33)


PERMANENT TOTAL SUPPLEMENTAL WORKSHEET
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Permanent Total Supplemental Worksheet (DFS-F2-DWC-35)


STATEMENT OF QUARTERLY EARNINGS
FOR SUPPLEMENTAL INCOME BENEFITS
DIVISION OF WORKERS’ COMPENSATION

Statement of Quarterly Earnings for Supplemental Income Benefits (DFS-F2-DWC-40)


AGGREGATE CLAIMS ADMINISTRATION CHANGE REPORT
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS’ COMPENSATION

Aggregate Claims Administration Change Report (DFS-F2-DWC-49)


If you are injured as a result of a work-related accident, your employer’s workers’ compensation coverage provides medical and partial wage replacement benefits that you may be entitled to.

Important Workers’ Compensation Information for Florida’s Workers (DFS-F2-DWC-60)


If you are injured as a result of a work-related accident, your employer’s workers’ compensation coverage provides medical and partial wage replacement benefits that you may be entitled to.

Important Workers’ Compensation Information for Florida’s Workers (DFS-F2-DWC-60)


IMPORTANT WORKERS’ COMPENSATION INFORMATION FOR FLORIDA’S EMPLOYERS

Important Workers’ Compensation Information for Florida’s Employers (DFS-F2-DWC-65)