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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 CCMSI iCE website. For further assistance, please email Kindra at or call (505) 837-8763.

Notice of Accident or Occupational Disease Disablement (pdf)

Employers' First Report of Injury (pdf)

Authorization to Release Medical Information (pdf)

CCMSI iCE Tutorial for Workers' Compensation (pdf)

Note:  You may type directly into these forms. In order to do this, please download the latest Adobe Reader.