Form 18m 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the employee’s name and address in the designated fields. Ensure accuracy as this information is crucial for processing.
3. Fill in the employer's name and address, along with the insurance carrier details. This section helps establish the context of your claim.
4. In Section A, provide the date of injury and a brief reason for requesting additional medical compensation. If you have supporting documentation, indicate whether it is attached.
5. Sign and date the form at the bottom of Section A. If applicable, include your attorney's contact information.
6. If you choose to complete Section B, have your treating physician fill out their details and sign to certify your need for additional medical care.

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