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What Do The Forms I Receive In The Mail Mean?

During the course of your claim, you are likely to receive any or all of the following forms:

  • •  Notice of employee's claim;
  • •  Award of compensation;
  • •  Compensation deferred and average weekly wage award;
  • •  Notice of issues filed;
  • •  Hearing Notice;
  • •  Continuance Notice;
  • •  Order of Compensation;
  • •  Stipulation Agreement;
  • •  Settlement Agreement.

Forms 1-7 above are sent to you by the Workers' Compensation Commission. Copies are also sent to your attorney and the employer/insurer.   The last two documents will often be used to resolve your claim and are prepared by your attorney.

Notice Of Employee's Claim

This is a blue form prepared by the Worker's Compensation Commission from the information provided on the original claim form which should be prepared with the assistance of your attorney.   This notice is an acknowledgment that your claim has been received by the Commission. You will notice that a claim number, starting with a letter and followed by six numbers, will appear in the top right hand corner. The bottom right hand corner will contain a consideration date.   This is not a hearing date. It is the last date your employer/insurer have to contest whether you can claim benefits for your injury. If you have not received this form in the mail you have not filed a claim!

Award Of Compensation

This is a form order that the claim is covered under the law. It is issued when the employer/insurer do not file a written document opposing your claim by the consideration date on the claim form. Although many wonderful things are listed in the award, you will not receive any of them unless you are entitled to them. The value of the award of compensation is that the carrier has forfeited the right to contest your eligibility to make a claim and you now have the right to request all the benefits available under Workers' Compensation law.

Compensation Deferred and Average Weekly Wage Award

Essentially, this form is the same as an award of compensation. The difference is that the claimant's average weekly wage has not been determined yet and/or that at this time there is no claim for benefits while you are missing work.

Notice Of Issues Filed

This form is received when somebody has requested a hearing before the Workers' Compensation Commission. Typically, if it is at the beginning of the case, it means the insurer has contested your claim before the consideration date. If it is later in the case, it is usually because your attorney has requested a hearing.

Hearing Notice

Hearings are scheduled when somebody files issues with the Workers' Compensation Commission. Sometime after the notice of issues filed is received, a hearing notice will be mailed to all of the parties. Usually the hearing notice will not be mailed outuntil several weeks before the actual hearing date. The injured worker must come to the hearing. Hearings are not cancelled unless a continuance is granted or schools are closed due to snow in the County where the hearing is scheduled. If you do not appear at the hearing you risk having your claim dismissed!

Continuance Notice

If either side requests a continuance the Commission will issue an order stating whether the request is granted, and who requested the continuance (often times the Commission notice is in error as to who requested the continuance). Continuances requested more than thirty days from the date of the hearing are routinely granted. If the request is less than thirty days from a hearing then they are rarely granted.

Order

This document represents the decision of the Commissioner on the issues presented at a hearing or approval of the parties proposed resolution of the case. The Order is final unless appealed within thirty days of the date of the order. If the empoyer/insurer appeal the case, they must comply with the Order unless it involves payment of previously incurred medical bills.

Stipulation Agreement

This is a document that has been prepared by your attorney on a form required by the Workers' Compensation Commission. It reflects an agreement by the parties on an issue that would otherwise be decided by a Commissioner at a hearing (usually the extent of permanent disability). There are two places for you to sign on the back of the form. One indicates your agreement to the stipulation and the second your acceptance of what your attorney is requesting for a fee and cost reimbursements. This document must be signed by a representative of the employer/insurer, the claimant, the claimant's attorney and then must be approved by the Commission.

Settlement Agreement

This is a document that has been prepared by your attorney on a form required by the Workers' Compensation Commission. It reflects an agreement by the parties that resolves forever some or all of your past and future rights to claim additional benefits. Usually, it involves a lump sum payment by the employer or its insurer.   You must sign the agreement and sign the accompanying affidavit. The document must also be signed by your attorney and a representative of the employer/insurer before it is presented to a Commissioner for approval.