Form WCB-122 Petition to Determine Average Weekly Wage - Maine

What Is Form WCB-122?

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-122?
A: Form WCB-122 is the Petition to Determine Average Weekly Wage in the state of Maine.

Q: What is the purpose of Form WCB-122?
A: The purpose of Form WCB-122 is to determine the average weekly wage of an injured worker for workers' compensation purposes.

Q: Who needs to file Form WCB-122?
A: Either the injured worker or the employer/insurer can file Form WCB-122 to request a determination of the average weekly wage.

Q: When should Form WCB-122 be filed?
A: Form WCB-122 should be filed within 30 days of the injury or within 60 days of the first payment of compensation, whichever is later.

Q: Is there a filing fee for Form WCB-122?
A: No, there is no filing fee for Form WCB-122.

Q: What information is needed to complete Form WCB-122?
A: To complete Form WCB-122, you will need to provide information about the injured worker's wages, such as gross earnings and number of days/hours worked.

Q: What happens after Form WCB-122 is filed?
A: After Form WCB-122 is filed, the Workers' Compensation Board will review the petition and make a determination of the average weekly wage.

Q: Can the determination of the average weekly wage be appealed?
A: Yes, either party (the injured worker or the employer/insurer) can appeal the determination of the average weekly wage.

Q: Are there any time limits for appealing the determination of the average weekly wage?
A: Yes, there are time limits for appealing the determination of the average weekly wage. The injured worker has 30 days to appeal from the date of the determination, while the employer/insurer has 60 days to appeal.