Resources

Workers’ Compensation Injury Forms Packet

The forms identified below can be downloaded for your convenience and will assist you in filing a Workers’ Compensation Claim. All claims must be filed via secure electronic portal at Online First Report. For further assistance, please contact our Bureau by calling (505) 827-2036 or 1-800-510-5093.

NOTE: RMD/WCB will be unable to accept the Workers’ Compensation Claims submitted unless all forms are completely filled out and submitted to the WCB.

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Authorization to Release Medical Information

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Benefit Explanation Form

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Doctor Visit / Modified Work Assignment

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Claim Explanation Form

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Notice of Accident or Occupational Disease Disablement

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Mileage Reimbursement Form

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Workers' Compensation Training_2019

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