New Claim Checklist:

  1. Accurately fill out WCB-1 (First Report of Injury)
  2. Save the pdf to your computer
  3. Email saved pdf to bperkins@workerscompme.com

Once Received By MMTA WCT:

  1. We will email you a final version of the WCB-1 (Frist Report of Injury)
  2. You will keep a copy for your records and provide a printed copy to the injured employee
  3. Email the following information to bperkins@workerscompme.com:

CMS Legal Documentation

(to ensure compliance with federal Medicare requirements)

Click Here

Supervisor's Report of Injury

(used as a loss control and claims mitigation tool)

Click Here

Employee's Report of Injury

(used as a loss control and claims mitigation tool)

Click Here

Medical Release Form

(necessary for the Trust to access employee’s medical records)

Click Here

Questions?

Contact us anytime:

 

Brianna Perkins

Sue Morang

Brian Parke

 

MMTA Workers' Comp. Trust

PO Box 5198

Augusta, ME 04332-5198

Phone: (207)623-1807

Fax: (207)622-6804