Workers' Compensation, RI Dept. of Labor and Training
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Employer Formsforms

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Automatic Calculation Wage Statements in Excel

Table is sortable by column

NOTE: Please fax your first reports of injury to (401) 462-8105.


Form Title
Form Number
Formats Available
Instructions
Employer's First Report of Alleged Occupational Injury or Disease
DWC-01
PDF | Excel
Instructions
Employee's Objection to Wage Transcript
DWC-31
PDF
Instructions
Wage Statement: Full Time
DWC-03F
PDF | Excel | Auto-Calc
Instructions | Tips
Wage Statement: Part Time
DWC-03P
PDF | Excel | Auto-Calc
Instructions | Tips
Wage Statement: Seasonal
DWC-03S
PDF | Excel | Auto-Calc
Instructions | Tips
Employee's Certificate of Dependency Status
DWC-04
PDF | PDF Fillable | Excel
Instructions
Notice of Claim of Common Law Rights (Waiver)
DWC-11
PDF
Not Available
Notice of Designation as an Independent Contractor
DWC-11-IC
PDF | Excel
Not Available
Notice of Insurance Policy Change
PC1 PC2
Electronic Submission Only
Contact NCCI
Notice of Withdrawal of Designation as Independent Contractor
DWC-11-ICR
PDF | Excel
Not Available
Rescind Notice of Claim of Common Law Rights
DWC-11R
PDF
Not Available
WC Act Summary Poster (English)
DWC-08
PDF
Not Available
WC Act Summary Poster (Spanish)
DWC-08S
PDF
Not Available
Election by Exempt Corporate Officer to Become Subject to Workers' Compensation
DWC-11C
---
Not Available,
call (401) 462-8100 option 7 for information.

 
RI Department of Labor and Training
Workers' Compensation
Center General Complex
1511 Pontiac Avenue, Cranston, RI 02920

Phone: (401) 462-8100
Fax (401) 462-8105
TTY via RI Relay: 711
2/21/13 MDF
State Seal
  DLT is an equal opportunity employer/program. Auxiliary aids and services available upon request