EDI Forms & Crosswalks Posted

We have updated the Alaska Workers' Compensation Forms Webpage (http://labor.state.ak.us/wc/pdf_list.htm) with the following forms that are effective Monday, July 22, 2013:

  • Compensation Report, Effective 07/22/2013 (Form 07-6104b)
  • Controversion (Denial) Notice, Effective 07/22/2013 (Form 07-6105)
  • EDI, Instructions for Use of Claims R3 Forms (Form 07-61XX)
  • EDI Crosswalk, Compensation Report (Form 07-6104b)
  • EDI, Controversion (Denial) Notice (Form 07-6105)
  • EDI Crosswalk, Employee Report of Occupational Injury or Illness to Employer (Form 07-6100)
  • EDI Crosswalk, Employer Report of Occupational Injury or Illness to Division of Workers’ Compensation (Form 07-6101)
  • Employee Report of Occupational Injury or Illness to Employer, Effective 07/22/2013 (Form 07-6100)
  • Employer Report of Occupational Injury or Illness to Division of Workers’ Compensation, Effective 07/22/2013 (Form 07-6101)