Form WCB-120 Petition for Review of Incapacity - Maine

Form WCB-120 Petition for Review of Incapacity - Maine

What Is Form WCB-120?

This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form WCB-120?A: Form WCB-120 is the Petition for Review of Incapacity in Maine.

Q: What is the purpose of Form WCB-120?A: The purpose of Form WCB-120 is to request a review of a worker's incapacity for work.

Q: Who can file Form WCB-120?A: The worker or their representative can file Form WCB-120.

Q: What information is required in Form WCB-120?A: Form WCB-120 requires information about the worker's identity, employer, injury, and medical treatment.

Q: Is there a deadline to file Form WCB-120?A: Yes, Form WCB-120 must be filed within two years from the date of the worker's injury or last payment of benefits.

Q: What happens after filing Form WCB-120?A: After filing Form WCB-120, a hearing will be scheduled to review the worker's incapacity.

Q: Can I appeal the decision made after the review?A: Yes, you can appeal the decision to the Maine Workers' Compensation Board Appellate Division.

Q: Is there a fee to file Form WCB-120?A: No, there is no fee to file Form WCB-120.

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Form Details:

  • Released on January 1, 2013;
  • The latest edition provided by the Maine Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form WCB-120 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Maine Workers' Compensation Board.

Download Form WCB-120 Petition for Review of Incapacity - Maine

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