Form WCB-4A Consent Between Employer and Employee - Maine

What Is Form WCB-4A?

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-4A?
A: Form WCB-4A is a Consent Between Employer and Employee form.

Q: What is the purpose of Form WCB-4A?
A: The purpose of Form WCB-4A is to obtain written consent from an employee in Maine for the release of their medical information related to a work-related injury or illness to their employer or insurer.

Q: Who needs to fill out Form WCB-4A?
A: Both the employer and the employee in Maine need to fill out Form WCB-4A.

Q: When should Form WCB-4A be filled out?
A: Form WCB-4A should be filled out when an employee in Maine sustains a work-related injury or illness and the employer or insurer needs access to their medical information.

Q: Is there a deadline for submitting Form WCB-4A?
A: There is no specific deadline for submitting Form WCB-4A, but it is advisable to complete and submit the form as soon as possible after the injury or illness occurs.

Q: Do both the employer and employee need to sign Form WCB-4A?
A: Yes, both the employer and employee need to sign Form WCB-4A.

Q: Can the employee revoke their consent in the future?
A: Yes, the employee has the right to revoke their consent at any time by providing written notice to the employer or insurer.