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Kansas Workers Compensation Forms

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Kansas Workers Compensation Insurance

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Please find the most common Kansas workers compensation forms, applications, and guides available online for your download and use.  We are always updating our KS forms library and are happy to answer your questions about any Kansas form or workers compensation coverage in general.

If you would like to get multiple quotes for workers compensation insurance in Kansas please call one of our Specialists today at 888.611.7467, or start a quote online by clicking the state of Kansas to the right.

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 KS Comp Forms


Kansas Workers Compensation Forms

Kansas Acord 130 Workers Compensation Application

The standard Acord 130 application form for workers comp coverage in Kansas.

Kansas Report of Injury Form

Report of Injury Form.  Employers should complete this form and send to their insurance company each time an injury occurs.

Kansas Application for Exclusion of Employees that own 10% corporate stock.

Election not to accept coverage under Kansas Workers' Compensation Act by an employee who ones 10% or more Corporate stock of corporate employer.

Kansas Application for Exclusion of Officers and Stockholders

Owners and Officers of corporations should complete this form to exclude themselves from a work comp policy.

Kansas Form to File a Claim for Workers' Compensation Insurance

Complete this form to file an injury claim for workers' compensation

Kansas Election on a Non-compensated Officer

Complete this form to elect coverage of a non-compensated volunteer officer, trustee of a nonprofit corporation to be covered under the Kansas Workers' Compensation Act.

Kansas Election of Employer to Cover Employees

Complete this form to elect coverage of employees under the Kansas Workers' Compensation Act where the employer has less than $20,000 Payroll or is an agricultural pursuit.

Kansas Election of Employer to Cover Volunteers

Complete this form for the election of the employer to provide workers' compensation coverage for volunteer workers.

Kansas Application for Exemption for Workers' Compensation Insurance

Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.

Elections Instructions

Information about filing for elections in the state of Kansas.

Important Information for Injured Workers

Information about the steps in filing a claim and an overview of workers' compensation claims.

Important Information for Injured Workers

An in depth guide to the practices and procedures in workers' compensation claims.

State Resources for Kansas

KS Insurance Department

420 SW Ninth Street
Topeka, KS 66612

Kansas Workers' Compensation

800 SW Jackson, Suite 600
Topeka, Kansas 66612-1227

State of Kansas


KS Department of Labor

401 SW Topeka Boulevard
Topeka, Kansas 66603-3182

KS Division of Workers’ Compensation

www.dol.ks.gov/WC/HTML/ wc_ALL.html
800 SW Jackson, Suite 600
Topeka, Kansas 66612-1227

KS Industrial Safety & Health

(800) 332-0353


Learn more about workers compensation insurance in Alabama

KS Department of Insurance

The Kansas Department of Insurance utilizes NCCI to provide statistical data used to determine workers compensation rates in KS on an annual basis.  Rates are approved by the state and NCCI administers both experience rating modifications and the Residual Market Plan, or State Fund, for Kansas.


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