Injured Workers Record Of Job Search Contacts {BWC-2960}

BWC-2960 / RH-10 -VOCATIONAL REHABILITATION PLAN JOB SEARCH CONTACTS. BWC requires you to report all earnings, including checks, cash or other remuneration, from any type of work activity or employment, including full-time, part-time, self-employment or commission work. You must provide all information requested for each job contact. Failure to complete the form in full could result in reductions in the benefit payable. Attach verifications of internet contacts to this form and complete this form weekly. You should use more than one form for each week. Submit your forms to your vocational rehabilitation case manager or employment specialist. If your employer is self-insured, mail your completed form(s) to your self-insuring employer. www.FormsWorkflow.com