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This version of the form is not currently in use and is provided for reference only. Download this version of
Form WCB-4D
for the current year.
Form WCB-4D Discontinuance of Compensation - Maine
What Is Form WCB-4D?
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-4D?
A: Form WCB-4D is a document used in Maine to discontinue workers' compensation benefits.
Q: Who uses Form WCB-4D?
A: Employers or insurers in Maine use Form WCB-4D to discontinue workers' compensation benefits.
Q: What is the purpose of Form WCB-4D?
A: The purpose of Form WCB-4D is to officially notify the injured worker that their workers' compensation benefits will be discontinued.
Q: How do I fill out Form WCB-4D?
A: You need to provide your personal information, the reason for discontinuing benefits, and any supporting documentation.
Q: Are there any deadlines for submitting Form WCB-4D?
A: Yes, Form WCB-4D should be submitted within 7 days of the decision to discontinue benefits.
Q: What happens after submitting Form WCB-4D?
A: The Workers' Compensation Board will review the form and may request additional information before making a decision.
Q: Can I appeal the discontinuance of benefits?
A: Yes, you have the right to appeal the decision to discontinue benefits by requesting an informal mediation or a formal hearing.
Q: Is there a fee for submitting Form WCB-4D?
A: No, there is no fee for submitting Form WCB-4D.
Form Details:
- Released on September 1, 2020;
- 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-4D by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
