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Disputed Claims

Disputes not resolved through the Informal Dispute Resolution process may only move forward if an Application for Adjustment of Claim (SF 29109) is filed. The case is then assigned to a Single Hearing Member of the Worker's Compensation Board for determination of all unresolved issues.

The Application for Adjustment of Claim must be filed with the Board within two years of the date of injury. After the Application is received by the Board it is assigned a cause number and set for a pre-trial conference or a hearing before the appropriate Single Hearing Member on the first available date in the appropriate location. The parties involved are notified of the setting, and one continuance is allowed each side. An employee may pursue a claim without an attorney; however, a corporation must be represented by legal counsel.

At the hearing, each party presents evidence. The injured worker has the burden of proving an accidental injury occurred in the course and scope of her employment in order to recover benefits. Medical evidence is extremely important.

After the hearing, the Single Hearing Member will prepare and serve an award upon the parties. The award details the stipulations of parties (issues which are not contested by the parties), findings of fact and the conclusions of law reached.

If either party is dissatisfied with the hearing member's award, an appeal may be filed with the Board. An appeal or Application for Review by Full Board (SF 1042) must be initiated within 30 days of the date of the award. Upon receiving the appeal, the case is set to be heard on the next available Full Board date; usually within three months. Appeals are not new hearings, but rather legal arguments made by each side to the full Worker's Compensation Board, which consists of all six Single Hearing Members and the Chairman. After the hearing, the full Board prepares and serves a written award upon the parties. Any further appeal must be made to the Court of Appeals, and then to the Supreme Court of Indiana.

Provider Fee Disputes

The Worker's Compensation Board also has exclusive jurisdiction over Provider Fee disputes.