Workers’ Compensation information and forms for the state of AK

Workers’ Compensation Insurance can seem complicated to administer. There are many forms and various specific state regulations concerning postings and employee notification. To get the help you need to ensure employees understand coverage’s and how to report a work place injury, select the link located below.

• 221-10000 – Claim Kit Cover Letter
  Letter from The Hanover welcoming the employer to the insurance plan, includes instructions for claim reporting and creating medical provider panels.
• 221-10001 – Take Control of Workers' Compensation Costs
  This guidance will help ensure the best outcome for you and your employees following a work related injury.
• WC8431p – Employer's Notice Of Insurance
  Required to be conspicuously posted at the employer's place of business so all employees have access to it. The notice shall be posted and kept on the premises of the employer or on the premises where the employer's operations are being carried on in three conspicuous places: at the office of the employer, at the mess house or boarding house if there is one, and in some conspicuous place on the premises or works.
• WC9433q – Employer Report of Occupational Injury/Illness
  This form is completed by the employer to report an on the job injury or accident involving an employee.
• WC9925 – Employee Report of Occupational Injury/Illness to Employer
  This form is completed by the employee when they have a work related injury. The employee should follow the instructions on the form and provide a copy to the appropriate parties.