Workers’ Compensation information and forms for the state of GA

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.
• WC7755p – Official Notice (Panel of Physicians)
  Required to be conspicuously posted at the employer's place of business so all employees have access to it. Employer can choose physicians at Talispoint or by contacting the workers' compensation claims adjuster at Hanover by calling 1-800-628-0250.
• WC8602e – Official Notice (Panel of Physicians) (Spanish)
  Required to be conspicuously posted at the employer's place of business so all employees have access to it. Employer can choose physicians at Talispoint, or, Employer can request a Physician Panel by emailing a request to wcmedstrat@hanover.com. Please be sure to include Policy #, location including address, and contact information.
• WC7867t – Bill Of Rights For The Injured Worker
  Required to be conspicuously posted at the employer's place of business so all employees have access to it.
• WC8601n – Bill Of Rights For The Injured Worker (Spanish)
  Spanish version - Required to be conspicuously posted at the employer's place of business so all employees have access to it.
• WC7794a – Employer's First Report of Injury or Occupational Disease
  This form is completed by the employer to report an on the job injury or accident involving an employee.