WCB Mission Statement
To provide efficient dispute resolution for injured workers and employers by administering both formal adjudication and informal dispute resolution services; to serve the public by answering inquiries regarding the Indiana Worker's Compensation system; and to collect statistical information regarding workplace injuries in Indiana.
News and Notices
Clarification Regarding Report of Attending Physician Form: As of this date, usage of the new State Form 2118, Report of Attending Physician, shall not be mandatory. The new SF 2118 is clear, concise and, most importantly, relevant to how PPI awards are accurately calculated for approval. Adjusters will ultimately be required to use it, as well as the electronic versions of SF 1043 and 38911, in the upcoming year. However, the Board will give advance notice of this requirement. Physicians will not be asked to complete this form but should use it as a guideline while dictating their own. We do encourage all interested parties to begin using this form, to which the physician’s dictated report can be attached, as soon as practicable. Thank you for your consideration and support.
Notice: The Board is hereby and immediately requesting that all Agreement to Compensation (SF 1043), Notice of Suspension of Medical Benefits (SF 54217), Notice of Denial of Benefits (SF 53914) and Request for Additional Time (SF 48557) forms be proceeded by an electronically filed First Report of Injury (FROI). Failure to do so will result in the rejection of your form. This is an administrative ruling. Notice: Please note that ALL balanced bill provider fee applications must be accompanied by the $60 filing fee. The presence of an existing application for adjustment of claim has no bearing on this mandate. Balanced bill provider fee applications received since 7/1/2011 are subject to this fee and will not be processed unless accompanied by said payment. Notice: The status report regarding the 2012 assessment for the Second Injury Fund is now available. Please click here to view. Notice: Proposed Rule, LSA Document # 11- 357 and Small Business Economic Impact Statement now available. Please follow the links to view. Notice: The 2011 Self-Insurance Guidelines and Application are now available. Please click here to view/download. Notice: SB 576 was enacted on May 9, 2011 and alters the Worker’s Compensation Act. The change to IC 22-3-3-5 is effective on July 1, and reads: “(d) All claims by a health care provider for payment for services are against the employer and the employer's insurance carrier, if any, and must be made with the board under IC 22-3-2 through IC 22-3-6. After June 30, 2011, a health care provider must file an application for adjustment of a claim for a health care provider's fee with the board not later than two (2) years after the receipt of an initial written communication from the employer, the employer's insurance carrier, if any, or an agent acting on behalf of the employer after the health care provider submits a bill for services. To offset a part of the board's expenses related to the administration of health care provider reimbursement disputes, a hospital or facility that is a medical service provider (as defined in IC 22-3-6-1) shall pay a filing fee of sixty dollars ($60) in a balance billing case. The filing fee must accompany each application filed with the board. If an employer, an employer's insurance carrier, or an agent acting on behalf of the employer denies or fails to pay any amount on a claim submitted by a hospital or facility that is a medical service provider, a filing fee is not required to accompany an application that is filed for the denied or unpaid claim. A health care provider may combine up to ten (10) individual claims into one (1) application whenever: Revised instructions for filing Applications for Adjustment of Claim for Provider Fee can be found here. Additional changes accompany this bill and can be found here. Notice: Effective May 1, 2011, the mileage reimbursement rate has increased from $0.40 to $0.44. As was the case in July of 2008, this change has been made to combat the rising costs of fuel. Notice: The Board takes no pre hoc position on the use of utilization review. Workers’ compensation and occupational disease cases are decided on the facts of the individual case as a whole. While an unreasonable denial or unreasonable delay of necessary medical treatment could result in penalties, employing utilization review will not, standing alone, justify penalties. The Board has not adopted the UR standards promulgated by the Indiana Department of Insurance. Therefore, those standards should not be taken as conclusively persuasive in an Indiana WC case.
(1) all individual claims involve the same employer, insurance carrier, or billing review service; and
(2) the amount of each individual claim does not exceed two hundred dollars ($200).”
