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STATE OF MAINE WORKERS COMPENSATION BOARD James J. MacAdam, Esq. MACADAM LAW OFFICES 208 Fore St Portland ME 04101DECISION NO.: WCB2130303Elizabeth Eddy Griffin, Esq. PIERCE ATWOOD One Monument Square Portland
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To fill out the wcb-213-03-03 workers compensation board, follow these steps:
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Start by entering your personal information, including your name, address, and contact details.
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Provide details about your employer, such as their name, address, and contact information.
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Fill in the date of injury or illness and provide a description of what happened.
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Indicate the body parts affected by the injury or illness and provide any available medical documentation.
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Provide information about any witnesses to the incident, if applicable.
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Sign and date the form, acknowledging that the information provided is true and accurate.
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Submit the completed form to the workers compensation board according to their instructions.

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Workers who have experienced a work-related injury or illness and are seeking compensation and benefits from the workers compensation board need to fill out the wcb-213-03-03 form. This form is required to initiate the claims process and provide important information about the incident.
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The WCB-213-03-03 is a specific form used by the Workers Compensation Board to collect information regarding workplace injuries and claims.
Employers who have employees that have been injured at work are required to file the WCB-213-03-03 form.
To fill out the WCB-213-03-03 form, employers need to provide details about the injured employee, the nature of the injury, the circumstances under which it occurred, and any relevant medical information.
The purpose of the WCB-213-03-03 form is to report workplace injuries to the Workers Compensation Board so that appropriate benefits and services can be provided to the injured worker.
The WCB-213-03-03 form must include information about the employee, details of the injury, the date and time of the incident, witness statements, and any medical treatments received.
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