Claim Dispute or Appeal

The Worker’s Compensation Board of Indiana can informally assist parties to resolve claim disputes or formally hear a disputed case before a hearing officer.

Procedure

Most workers compensation claims are resolved without dispute. If questions or disagreements arise between the employer, carrier, and employee, the Worker’s Compensation Board of Indiana, Ombudsman Division, may be able to informally assist the parties in resolving the problem. Disputes may also be resolved through a hearing before the Worker`s Compensation Board.You can contact the Ombudsman with general questions or problems by calling the Ombudsman Division at: (800) 824-2667 or (317) 232-5922.

As a procedural matter, a carrier must make a reasonable judgement if a claim is compensable and if the policy provides coverage. An employer or employee have an opportunity to question a carrier’s decision via the Application for Adjustment of Claim filed with the Board.

Legal Question

There are few absolutes in deciding state jurisdiction. Each state’s Board or Commission makes a coverage determination, such as deciding which state’s benefits apply.

Whether certain employees are covered under the policy is a legal question, which must be determined, based on state law and the state’s definition of “employment,” or “employee,” or “state of hire.” The legal decision-maker on such an issue in Indiana is the Workers Compensation Board of Indiana.

Board Form

Any injured person may file an Application for Adjustment of Claim with the Board to receive a determination of whether he was an employee eligible for Indiana benefits when injured.

Application for Adjustment of Claim

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