How to File a Claim Checklist

* We recommend the First Report of Injury be submitted within 24-48 hours of employer’s knowledge or notice of an injury or claim to avoid penalties assessed by the Workers Compensation Board.

1. Employer’s First Report of Occupational Injury or Disease (WCB-1) (FIRST REPORT)

2. Supervisor’s Incident Report

3. Employee’s Incident Report

** Above forms must be emailed to Betti-Jeanne Bullock at bjbullock@msmaweb.com or faxed to (207) 620-7090.

Other forms that may be required/requested: