8 Alaska Admin. Code § 45.050 : Labor and Workforce Development — Workers' Compensation — Compensation, Medical Benefits, and Proceedings Before the Alaska Workers' Compensation Board — Pleadings

(a) A person may start a proceeding before the board by filing a written claim or petition.

(b) Claims and petitions.

(1) A claim is a written request for benefits, including compensation, attorney's fees, costs, interest, reemployment or rehabilitation benefits, rehabilitation specialist or provider fees, or medical benefits under the Act, that meets the requirements of (4) of this subsection. The board has a form that may be used to file a claim. In this chapter, an application is a written claim.

(2) A request for action by the board other than by a claim must be by a petition that meets the requirements of (8) of this subsection. The board has a form that may be used to file a petition.

(3) Parties must be designated in accordance with 8 AAC 45.170.

(4) Within 10 days after receiving a claim that is complete in accordance with this paragraph, the board or its designee will notify the employer or other person who may be an interested party that a claim has been filed. The board will give notice by serving a copy of the claim by certified mail, return receipt requested, upon the employer or other person. The board or its designee will return to the claimant, and will not serve, an incomplete claim. A claim must

(A) state the names and addresses of all parties, the date of injury, and the general nature of the dispute between the parties; and

(B) be signed by the claimant or a representative.

(5) A separate claim must be filed for each injury for which benefits are claimed, regardless of whether the employer is the same in each case. If a single incident injures two or more employees, regardless of whether the employers are the same, two or more cases may be consolidated for the purpose of taking evidence. A party may ask for consolidation by filing a petition for consolidation and asking in writing for a prehearing, or a designee may raise the issue at a prehearing. To consolidate cases, at the prehearing the designee must

(A) determine the injuries or issues in the cases are similar or closely related;

(B) determine that hearing both cases together would provide a speedier remedy; and

(C) state on the prehearing summary that the cases are consolidated, and state which case number is the master case number.

(6) After cases have been consolidated under (5) of this subsection,

(A) a pleading or documentary evidence filed by a party must list the master case number first and then all the other consolidated case numbers;

(B) a compensation report, controversion notice, or a notice under AS 23.30.205(f) must list only the case number assigned to the particular injury with the employer filing the report or notice;

(C) documentary evidence filed for one of the consolidated cases will be filed in the master case file; the evidence is part of the record in each of the consolidated cases; and

(D) the original of the board's decision and order will be filed in the master case file, and a copy of the decision and order will be filed in each of the consolidated case files.

(7) After the board hears the consolidated cases and, if appropriate, the division will separate the case files and will notify the parties. If the consolidated case files are separated, a pleading or documentary evidence filed thereafter by a party must list only the case number assigned to the particular injury with the employer filing the pleading or documentary evidence.

(8) Except for a petition for a self-insurance certificate or an executive officer waiver, a petition must be signed by the petitioner or representative and state the names and addresses of all parties, the date of injury, and the general nature of the dispute between the parties. The petitioner must provide proof of service of the petition upon all parties. The board or its designee will return to the petitioner a petition which is not in accordance with this paragraph, and the board will not act on the petition. A petition alleging that disability has ended or an impairment became permanent must

(A) state the dates for which compensation was paid;

(B) state the amount of compensation paid to the employee;

(C) state the date on which the petitioner claims the disability ended or the impairment became permanent; and

(D) be accompanied by a completed medical summary on form 07-6103.

(c) Answers.

(1) An answer to a claim for benefits must be filed within 20 days after the date of service of the claim and must be served upon all parties. A default will not be entered for failure to answer, but, unless an answer is timely filed, statements made in the claim will be deemed admitted. The failure of a party to deny a fact alleged in a claim does not preclude the board from requiring proof of the fact.

(2) An answer to a petition must be filed within 20 days after the date of service of the petition and must be served upon all parties.

(3) An answer must be simple in form and language. An answer must state briefly and clearly the admitted claims and the disputed claims so that a lay person knows what proof will be required at the hearing and, when applicable, state

(A) any reason why the claim or dispute cannot be heard completely at the first hearing;

(B) whether the claim is barred under AS 23.30.022, 23.30.100, 23.30.105, 23.30.110, or otherwise barred by law or equity;

(C) whether the injury was proximately caused by the employee's willful intent to injure or kill any person;

(D) whether the injury was proximately caused by the employee being intoxicated or being under the influence of a drug or combination of drugs;

(E) whether the last injurious exposure rule applies;

(F) whether the employee has failed to minimize the disability, giving specifics of the allegation;

(G) whether the employee has been overpaid or paid at a different rate than that which is due; and

(H) whether the employee's compensation rate should be adjusted under AS 23.30.175(b).

(4) A general denial is not an answer.

(5) The evidence presented at the hearing will be limited to those matters contained in the claim, petition, and answer, except as otherwise provided in this chapter.

(6) Upon a verified petition of a party or upon its own motion, the board will, in its discretion, extend or postpone the time for filing an answer or otherwise continue the proceedings under such terms as may be reasonable.

(d) Replies.A reply is a response to an answer. No party is required to file a reply. However, a reply, if filed, must be filed within seven days of service of the answer upon the parties.

(e) Amendments.A pleading may be amended at any time before award upon such terms as the board or its designee directs. If the amendment arose out of the conduct, transaction, or occurrence set out or attempted to be set out in the original pleading, the amendment relates back to the date of the original pleading. An amendment changing the party against whom a claim is asserted relates back if, additionally,

(1) within the period provided by AS 23.30.105 for filing a claim, the party to be brought in by amendment has received, under AS 23.30.100, such notice of the injury that the party will not be prejudiced in defending the claim; and

(2) the party to be joined by the amendment knew or should have known that, but for a mistake concerning the identity of the proper party, the action would have been brought against the party.

(f) Stipulations.

(1) If a claim or petition has been filed and the parties agree that there is no dispute as to any material fact and agree to the dismissal of the claim or petition, or to the dismissal of a party, a stipulation of facts signed by all parties may be filed, consenting to the immediate filing of an order based upon the stipulation of facts.

(2) Stipulations between the parties may be made at any time in writing before the close of the record, or may be made orally in the course of a hearing or a prehearing.

(3) Stipulations of fact or to procedures are binding upon the parties to the stipulation and have the effect of an order unless the board, for good cause, relieves a party from the terms of the stipulation. A stipulation waiving an employee's right to benefits under the Act is not binding unless the stipulation is submitted in the form of an agreed settlement, conforms to AS 23.30.012 and 8 AAC 45.160, and is approved by the board.

(4) The board will, in its discretion, base its findings upon the facts as they appear from the evidence, or cause further evidence or testimony to be taken, or order an investigation into the matter as prescribed by the Act, any stipulation to the contrary notwithstanding.

8 AAC 45.050

In effect before 7/28/59; am 5/28/83, Register 86; am 12/14/86, Register 100; am 3/16/90, Register 113; am 7/20/97, Register 143; am 7/2/98, Register 146

Authority:AS 23.30.005

AS 23.30.012

AS 23.30.022

AS 23.30.100

AS 23.30.105

AS 23.30.110

AS 23.30.135

AS 23.30.175

AS 23.30.190

AS 23.30.235