The documents below are relevant to employers.
Click here to view forms for employers.

Fax Policy

All Commission facsimile (fax) equipment and services are available to receive documents 24 hours a day, 7 days a week.

Any document submitted by fax shall be deemed filed with the Commission as of the date and time it is received by the Commission’s fax equipment or service agent to which it has been sent.

Telephone Disclosure Guidelines

The Commission has implemented guidelines to its employees to help ensure that information for determining eligibility for employment is not provided without the written consent of the employee. The procedures outlined in the Telephone Disclosure Guidelines are used by the Commission personnel in determining what information will be disclosed upon telephone inquiry. To view the complete Telephone Disclosure Guidelines, please see the link above.

Hearing Loss Table

A Commission-issued table for determining the compensable percentage of hearing loss. The average decibel loss is to be translated into percentage of compensable hearing loss of each ear, according to the calculations in this table.

Snellen's Chart

The Snellen's Chart is a chart developed in 1862 by the Dutch ophthalmologist Herman Snellen, the son of the renowned physician, Dr. F. A. Snellen. The younger Snellen studied medicine in The Netherlands under Gerard Johann Mulder, Jacobus Ludovicus Conradus Schroeder van der Kolk, and Franz Cornelis Donders. He received his medical doctorate at Utrecht in 1858.

Dr. Snellen's chart is used to measure the percentage of loss of visual acuity.

Mediation Policies

Effective April 19, 2022 the format to be used in Issue Mediation or Full and Final Mediation may be via videoconference, telephone, in person, or some hybrid of the three, subject to the discretion of the mediator and the agreement of the parties.

Completed Wage Chart (8+ Days)

Example of a Wage Chart where an 8-day gap is involved. This could include weeks that an employee was off payroll for unpaid leave for various reasons.

These periods should be noted on the chart using an asterisk (*) in the “Gross amount paid, including overtime” column and are not to be counted in the calculations.

Completed Wage Chart

Example of a Wage Chart properly completed for a 52 week period preceding the accident.
Complete the weekly gross wages, number of days worked and the week ending date for the full 52 weeks, or applicable number of weeks available prior to the date of accident. Earnings for a similar employee may be used if the employee has worked less than 60 days.