Code of Maine Rules
90 - INDEPENDENT AGENCIES
351 - WORKERS' COMPENSATION BOARD
Chapter 2 - SECTION 213 COMPENSATION FOR PARTIAL INCAPACITY
Appendix 351-2-I
Universal Citation: 90 ME Code Rules ยง 351-2-I
Current through 2024-13, March 27, 2024
(Employees must provide the following information to the employer/insurer within 30 days of filing the Petition for Extension of Benefits.)
1. State what your present financial condition is (i.e. present monthly income vs. present monthly expenses).
2. State when and where you have looked for work in at least the last 3 months.
3. Provide a copy of your most recent tax return, if one was filed.
4. Please provide any other information that may be relevant to your present financial condition that you plan to rely on at hearing.
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