* 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)

• All First Report of Injuries (FROI) received by 3:00 PM will be processed the same business day. Any FROIs received after 3:00 PM will be processed the next business day.

2. Supervisor’s Incident Report

3. Employee’s Incident Report

** Above forms must be emailed to Leslie Carr at lcarr@msmaweb.com or faxed to (207) 620-7090.

Other forms that may be required/requested:

• Fringe Benefit Worksheet (WCB-2B)

• Wage Statement (WCB-2) 

• Mileage Reimbursement Form

• Limited Certificate - Medical Authorization (WCB-220)

• CMS (Centers for Medicare Services) Legal Documentation