Hawaii Form Center -
Type & Print Forms - programmed for direct type and print functionality.
Each form may be downloaded
in Adobe Acrobat format. Download the form by clicking on the form number below.
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|wc-1.pdf||Employer's Report of Industrial Injury|
|wc-3.pdf||Carrier's Case Report - Per DOL must be filed in duplicate on pink paper.|
|wc-5.pdf||Employee's Claim for Workers' Compensation Benefits|
|wc-5a.pdf||Dependent's Claim for Compensation|
|wc-14.pdf||Employee's Wage Report|
|wc-21.pdf||Application for Self-Insurance Authorization|
|wc-42.pdf||Request for Information or Photo Copies|
|wc-77.pdf||Application for Hearing|
|wc-77a.pdf||Response to Application for Hearing|
|Attorney-Fee-Request.pdf||Request for Approval of Attorney's Fee|
|attorney_hourlyrate_increase.pdf||Request for Increase in Hourly Rate|
|lir27.pdf||Application for Certificate of Compliance with Section 3-122-112, HAR|
|highlights.pdf||BROCHURE - Highlights of the Hawaii Workers' Compensation Law|
|labor-law-poster.pdf||POSTER - Labor Law Posters (Complete set)|
|Special-Instructions.pdf||Special Instructions for Insurance Carriers, Adjusters and Self-Insured Employers to Complete and File Industrial Accident (WC-1), Physician (WC-2) and Carrier Case (WC-3) Reports Under the Hawaii Workers' Compensation Law|