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Required DOE forms to file for Workers' Compensation
If you are filing for workers’ compensation, you must file these forms:
Educational Paraprofessional Leave Application
Educational paraprofessionals should use this form for initial requests for leaves of absence as well as requests for extensions. Requests for extensions must be submitted prior to the date of expiration of the current leave.
EB1054 Health Benefits Report/Inquiry
You should submit this report with your Educational Paraprofessional Leave Application to prevent the disruption of your major medical insurance.
Dental Claim Form
After you have read the dental claim form instructions (below) you are ready to fill out the dental claim form as needed.
School Nurse Timesheet
Office of School Health Time Report for Nurses.
Facility-Wide Inventory of Mercury and Mercury-Containing Devices
Especially for Lab Specialists. Use Page 1 to document the presence of mercury in a science room.
Extended Session Grievance Form, Step 1
Extended Session Teacher/Student Ration Fact Sheet