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Division of Workers' Compensation

Transmittals

Form

Description

First Report Transmittal 

Form #WC 106   

Fillable  pdf MS Word

 

 

This form is used by the insurer to transmit Employers First Reports of Injury to the Division. 

Workers’ Claim for Compensation Transmittal 

Form #WC174 

Fillable  pdf MS Word


 

 

This form is used by attorneys to submit Worker’s Claims for Compensation and should be accompanied by an Entry of Appearance Form (WC6). 

 

 

 

 

All Applicable Rights Reserved, Copyright 2004 Colorado Department of Labor and Employment