PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form WCB-170
for the current year.
Form WCB-170 Petition for Restoration - Maine
What Is Form WCB-170?
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-170?
A: Form WCB-170 is a petition for restoration in the state of Maine.
Q: What is a petition for restoration?
A: A petition for restoration is a form used to request the reinstatement of workers' compensation benefits.
Q: Who can file Form WCB-170?
A: The injured worker or their attorney can file Form WCB-170.
Q: What information is required in Form WCB-170?
A: Form WCB-170 requires information about the injured worker, their employer, and the reason for requesting restoration of benefits.
Q: Is there a deadline for filing Form WCB-170?
A: Yes, Form WCB-170 must be filed within two years from the date the employer last paid benefits or within two years from the date of injury if no benefits were paid.
Form Details:
- Released on January 1, 2013;
- 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-170 by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
