Recovery and Return (R&R) Award

Nomination Form

Please complete the form below to submit your nomination for the R&R Award. If you prefer to submit your nomination by mail, click the icon above to download the .pdf and mail the completed form to: 

Mississippi Workers’ Compensation Association • P. O. Box 13508 • Jackson, MS 39236-3508

RECOVERY & RETURN AWARD (R&R) NOMINATION FORM

The R&R award is presented annually by the MWCEA to an injured worker in Mississippi that has demonstrated exceptional motivation to obtain physical recovery and return to the productive workforce.

Nominee Information

Please submit current details and contact information for the worker you wish to nominate.



Employer Information

Please provide details and contact information for the nominee's employer at the time of the injury.



Nominator Information

Please provide name and contact information for the individual submitting the nomination (if other than employer.)



Injury Details