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Forms cannot be filed by email/attachment or FAX; only original forms with original signatures are accepted.

Forms submitted must be current and as provided by the Commission.  Altered, created/unauthorized or obsolete forms are not accepted. 

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Select a link category from the choices below to navigate to available forms.
Address/Information Change Forms Insurance, Compliance & Reporting Forms
Settlement Related Forms Subpoena & Medical/Release Related Forms
Employer Designee to Receive Notice of Employee Claims Download Adobe® Reader
Claims for Death Benefits Instructions for completing Adobe Reader Fillable Forms
   

CLAIMS

DEATH CLAIMS Forms & Information  (Page)


SETTLEMENT

Medicare Set-Aside informational materials - January/February 2010


SUBPOENA & Medical Release 

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ADDRESS OR INFORMATION CHANGE
Miscellaneous, Other & Statutory Filing     Back to top
 The MD WCC Employer's Posting Notice (Form C- 24, Version 11/2007;  English/Spanish PDF for printing via Adobe® Reader - 325 KB).
The MD WCC Employers' Posting Notice is 8.5" X 14" and MUST be printed on 8.5" X 14" (legal size) goldenrod or yellow paper.  Laser printer or clear photocopier versions are recommended for printed durability and legibility.  Default resolution for this printing is 600 dpi (dots per inch).  The statutory requirement is "as provided by the MD WCC", hence reduced size or otherwise altered reproductions from the original/default specifications will not constitute statutory compliance.  The Notice is to be posted in a conspicuous location at each worksite and must include the complete employer/insurer information in the lower left corner where indicated.

EMPLOYER'S POSTING NOTICE, C-24 (print only)

EMPLOYER'S POSTING NOTICE, C-24 (fillable for printing)

 

REQUEST THE WCC EMPLOYER'S FIRST REPORT OF INJURY FORM  or WCC EMPLOYEE CLAIM FORM #C-1 9/2007 .
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