Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11

Workers' Comp Forms

Friday, May 24, 2019 - 12:00

Download and submit this form by email to Labor.WCfirstreport@vermont.gov or fax to 802-828-2195.

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Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11 (53.48 KB)

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