State Forms


Workers' Compensation

Temporary Disability Insurance (TDI)

For employees:

Claim forms are not available online. Ask your employer for a claim form or contact us if your employer does not have the claim form.


Prepaid Healthcare (PHC)

  • HC-5 Employee Notification to Employer: 2017 | 2018

For employers:

For Health care Contractors:

General Forms



Next HIWA Meeting

Hawaii Injured Workers Meetings 2017

Our Non-Profit Status


On 12/12/2012 HIWA was granted its non-profit status by the IRS, effective as of 11/30/2011

ER ID No. 45-4038392


Donate Today


HIWA is a 501(c) (3) non-profit organization

Call: (808) 538-9771