COLA Request Form (CA51)
The injured worker must file a COLA Request Form every year in order to apply for the applicable cost of living adjustments.
Insurers
Award Agreement
OR
File Online: WebFile users may upload this form through their account. Click here to learn more about WebFile.
Attending Physician's Report (Form 6)
The treating physician completes this form and the report provides specific medical information including date of accident, diagnosis, prognosis, the disability period(s), and the extent of any permanent disability. This form must be signed by the treating physician.
In cases of amputation for hand/foot, the treating physician completes this form and may fill out the Amputation Chart.