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

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

Form – Workers’ Compensation Attachment F – Doctor Visit – Modified Work Assignment Form

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