Free Maine Workers Compensation Forms

56 Forms found in Maine — Workers Compensation — Page 1 of 2
Title Last Updated
Complaint For Audit May 22, 2019
Statement Of Compensation Paid April 18, 2019
Request For Expedited Proceeding April 18, 2019
Notice Of Controversy April 18, 2019
Memorandum Of Payment April 18, 2019
Employee Expense Form April 18, 2019
Discontinuance Or Modification Of Compensation April 18, 2019
Consent Between Employer And Employee April 18, 2019
Certificate Of Discontinuance Or Reduction Of Compensation April 18, 2019
Limited Release Of Medical Health Care Information November 26, 2018
Notice Of Intent To Appeal November 26, 2018
Providers Petition For Payment Of Medical And Related Services April 30, 2018
Employers First Report Of Occupational Injury Or Disease January 12, 2018
Request For Independent Medical Examination May 16, 2016
Petition To Remedy Discrimination May 16, 2016
Petition To Determine Extent Of Permanent Impairment May 16, 2016
Petition To Determine Average Weekly Wage May 16, 2016
Petition For Restoration May 16, 2016
Petition For Reinstatement May 16, 2016
Petition For Review Of Incapacity May 16, 2016
Petition For Award Of Compensation - Fatal May 16, 2016
Petition For Award Of Compensation - Occupational Disease Law May 16, 2016
Petition For Award Of Compensation May 16, 2016
Petition For Payment Of Medical And Related Services May 16, 2016
Motion For Award Of Fees And Disbursements May 16, 2016
Employment Status Report May 16, 2016
Employees Return To Work Report May 16, 2016
Employee Petition For Review Of Incapacity And Request For Provisional Order May 16, 2016
Release Of Unemployment Information May 16, 2016
Employees Return To Work Report May 16, 2016
Fringe Benefits Worksheet May 16, 2016
Petition For Extension Of Benefits Due To Extreme Financial Hardship May 16, 2016
Petition To Determine Entitlement To Rehabilitation Services May 16, 2016
Application For Evaluation Employment Rehabilitation Services May 16, 2016
Petition For Review Of Extended Benefits Awarded Due To Extreme Financial Hardship March 30, 2016
Wage Statement March 30, 2016
Schedule Of Dependents And Filing Status Statement March 30, 2016
Practitioners Report March 11, 2016
Lump Sum Settlement March 11, 2016
Application For Predetermination Of Independent Contractor Status (Rebuttable Conclusive Presumption) September 2, 2015
Certificate Authorizing Release Of Benefit Information September 2, 2015
Application For A Certificate Of Independent Status April 13, 2015
Application For Waiver April 13, 2015
Application For Predetermination Of Independent Contractor Status To Establish Conclusive Presumption April 13, 2015
Complaint For Penalties March 15, 2013
Application For Wage Credit Rehabilitation Fund March 15, 2013
Petition For Forfeiture February 14, 2013
Complaint For Audit October 11, 2012
Application For Predeterm Construction Subcontractor Establish A Rebuttable Presumption December 1, 2010
Notice Of Workers Compensation Insurance May 15, 2006