[wcb] WCB Form Revisions Effective 4-1-25

[Lizzotte, Lindsay]

On December 10, 2024, the Workers' Compensation Board of Directors voted to adopt changes to the forms listed below. The effective date of these forms is April 1, 2025.

WCB-2 Wage Statement
WCB-3 Memorandum of Payment
WCB-4D Discontinuance of Compensation
WCB-4M Modification of Compensation

PDF and Microsoft Word copies of the new forms are attached. Fillable PDFs will be added to the WCB website<https://www.maine.gov/wcb/forms/index.html> before the effective date.

Lindsay Lizzotte
Deputy Director of Information Mgmt.
Maine Workers' Compensation Board
Lindsay.Lizzotte at maine.gov<mailto:Lindsay.Lizzotte at maine.gov>

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