LAC 40:I.1103 – Forms; Preparation and Adoption; Use

A. The Office of Workers' Compensation shall prepare and adopt such forms for use in workers' compensation cost containment as it may deem necessary and advisable. Whenever the Office of Workers' Compensation's forms are prescribed and are applicable, they shall be used. A photo ready copy of any form may be procured upon request to the office.
B. The following forms have been adopted by the Office of Workers' Compensation Administration for use in the implementation of the Workers' Compensation Cost Containment Act.
Forms
LW-WC-Form No. 1021 Application for Attendance at Cost Containment Meeting
LW-WC-Form No. 1024 Certificate of Satisfactory Implementation of Occupation Safety and Health Program

Forms
LW-WC-Form No. 1021	Application for Attendance at Cost Containment Meeting
LW-WC-Form No. 1024	Certificate of Satisfactory Implementation of Occupation Safety and Health Program

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1178.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Labor, Office of Workers' Compensation Administration, LR 19:896 (July 1993), amended by the Louisiana Works, Office of Workers' Compensation Administration, LR 52:504 (April 2026).