All Maine Workers Compensation forms

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Discovery

• Claimant's First Set of Requests for Production US-01366
• Claimant's First Set of Interrogatories to Employer and Carrier US-01365
• Requests for Production of Documents to Carrier US-01367

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Official - Awards

• Motion for Award for Workers' Compensation ME-WCB-25-WC
• Petition for Award of Compensation for Workers' Compensation ME-WCB-140-WC
• Petition for Award of Compensation Occupational Disease for Workers' Compensation ME-WCB-160-WC

Workers Compensation - Official - Consents

• Consent for Workers' Compensation ME-WCB-4A-WC

Workers Compensation - Official - Controversion

• Notice of Controversy for Workers' Compensation ME-WCB-9-WC

Workers Compensation - Official - Death Claims

• Petition for Award of Compensation Fatal for Workers' Compensation ME-WCB-150-WC

Workers Compensation - Official - Dependents

• Schedule of Dependents for Workers' Compensation ME-WCB-2A-WC

Workers Compensation - Official - Discrimination

• Petition to Remedy Discrimination for Workers' Compensation ME-WCB-195-WC

Workers Compensation - Official - Employers

• Employers First Report for Workers' Compensation ME-WCB-1-WC

Workers Compensation - Official - Expedited Proceedings

• Request for Expedited Proceeding for Workers' Compensation ME-WCB-250-WC

Workers Compensation - Official - Impairment

• Petition to Determine Impairment for Workers' Compensation ME-WCB-180-WC

Workers Compensation - Official - Independent Status

• Independent Status Application for Workers' Compensation ME-WCB-262-WC

Workers Compensation - Official - Lump Sums

• Lump Sum Settlement for Workers' Compensation ME-WCB-10-WC

Workers Compensation - Official - Medical Examinations

• Request for IME for Workers' Compensation ME-M2-WC

Workers Compensation - Official - Medical Records

• Limited Certificate for Workers' Compensation ME-WCB-220-WC

Workers Compensation - Official - Payments

• Discontinuance or Modification of Payment for Workers' Compensation ME-WCB-4-WC
• Providers Petition to Pay Medical for Workers' Compensation ME-WCB-190A-WC
• Memorandum of Payment for Workers' Compensation ME-WCB-2-WC
• Petition for Payment of Medical for Workers' Compensation ME-WCB-190-WC

Workers Compensation - Official - Reductions

• Certificate Discontinuance or Reduction for Workers' Compensation ME-WCB-8-WC

Workers Compensation - Official - Releases

• Release of Benefit Information for Workers' Compensation ME-WCB-6-WC

Workers Compensation - Official - Reports

• Employment Status Report for Workers' Compensation ME-WCB-230-WC
• Employees Return to Work Report for Workers' Compensation ME-WCB-231-WC
• Practitioners Report - Workers' Compensation ME-M1-WC

Workers Compensation - Official - Restoration

• Petition for Restoration for Workers' Compensation ME-WCB-170-WC

Workers Compensation - Official - Reviews

• Employee Petition for Review of Incapacity for Workers' Compensation ME-WCB-121-WC
• Petition for Review of Incapacity for Workers' Compensation ME-WCB-120-WC

Workers Compensation - Official - Statements

• Statement of Compensation Paid for Workers' Compensation ME-WCB-11-WC

Workers Compensation - Official - Wages

• Wage Statement for Workers' Compensation ME-WCB-3-WC
• Petition to Determine AWW for Workers' Compensation ME-WCB-122-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Releases

• Certificate Authorizing Release of Information for Workers' Compensation ME-WCB-221-WC