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  • Non Medical Services Form - Wyoming Department Of Workforce ... - Wyomingworkforce

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Click here to Clear Form STATE OF WYOMING DEPARTMENT OF WORKFORCE SERVICES DIVISION OF WORKERS' COMPENSATION CLAIM FOR NON-MEDICAL SERVICES 307-777-7441 PLEASE PRINT OR TYPE IN BLACK INK Injured Worker.

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If you quit your job, you will be disqualified from receiving unemployment benefits unless you had good cause. In general, good cause means that your reason for leaving the position was job-related and was so compelling that you had no other choice than to leave.

You must apply for TTD benefits using an Application for Temporary Total Disability. A report of injury is not a claim for TTD benefits. TTD benefits are the equivalent of 2/3 of your gross monthly wage at the time of injury, but cannot exceed the Statewide Average Wage for the quarter you were injured.

Name, address, and phone number for your most recent employer. Date of the last day you worked. For any work completed outside of Wyoming over the previous 18 months, contact information and dates for those employers and periods of work. Your Social Security number.

To file your weekly claim by phone, call (307) 473-3789.

Contact (307) 777-5476, or email DWS-AskMeWC@wyo.gov. Please call (307) 777-7441 to access our Integrated Voice Response system for your claim information.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232