Forms

Employer’s first report of injury

Employers should use this form to report an incident/injury to MAA.

Incident Report

Employees should use this form to report an incident/injury to their employer.

Supervisors Accident report

Supervisors should use this form to report incident/accident investigation information to MAA.

Authorization to Release

Injured employees are required to sign this form as a release for MAA to obtain personal medical information.

RTW Form

Physicians should use this form to report the treatments that are administered to the injured employee.

STD/LTD form

STD and LTD claimants should use this form to complete the claim process. STD claimants should complete the form at the onset of their disability. LTD claimants are required to have their physician sign a new form every three months for the duration of the claim period.