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Workers’ Compensation

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Workers’ Compensation

Form - Workers' Compensation Attachment A - Notice of Accident of Occupational Disease Disablement Form NOA-A-W

Form - Workers' Compensation Attachment B - Employers' First Report of Injury or Illness - Online Form Instructions

Form - Workers' Compensation Attachment C - Worker's Compensation Claim Explanation Form

Form - Workers' Compensation Attachment D - Workers' Compensation Benefits Explanation Form

Form - Workers' Compensation Attachment E - Workers' Authorization for Disclosure of Protected Health Information updated 7-2016

Form - Workers' Compensation Attachment F - Doctor Visit - Modified Work Assignment Form

Workers' Compensation Policy NMJB Policy No.2016.NMJB.200 - FINAL 6-1-17