New Hampshire Claims Forms
|Document||What It Is||When To Use/File|
|Claim Kit||Cove Risk’s exclusive guide for employers and injured workers including forms for proper filing of claims and other necessary information pursuant to New Hampshire Workers’ Compensation Law.||Whenever an injury occurs (contains the most commonly used claim forms).|
|Form 8WC||First report of injury.
Secure Form: You may fill out and submit online. For instructions click here
|ASAP after the injury occurs.|
|Form 76 WCA||Wage Schedule.||Employer must forward to Cove Risk no later than employee’s fifteenth day of disability relating from industrial accident.|
|Form 13 WCA||Employer’s Supplemental Report of Injury.||File as soon as possible after date of knowledge of an occupational injury or disease but no later than ten days thereafter. Submit also upon employee’s return to work.|