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Maine School Management Association
Documents
Documents
Insurance Programs
Workers' Compensation
How to File A Claim
Name
Type
Size
Name:
Employer's First Report of Occupational Injury or Disease
Type:
pdf
Size:
265 KB
Name:
Supervisor's Incident Report
Type:
doc
Size:
84 KB
Name:
Employee's Incident Report
Type:
doc
Size:
83.5 KB
Name:
Limited Certificate - Medical Authorization
Type:
pdf
Size:
72.9 KB
Name:
Centers for Medicare Services Legal Documentation
Type:
pdf
Size:
62.3 KB
Name:
Fringe Benefit Worksheet
Type:
pdf
Size:
99.3 KB
Name:
Wage Statement
Type:
pdf
Size:
99.5 KB
Name:
Mileage Reimbursement Form
Type:
doc
Size:
40 KB