8 Alaska Admin. Code § 45.050

Current through September 25, 2024

Section 8 AAC 45.050 - Pleadings

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

(b) For claims and petitions under this subsection,

(1) a claim is a written request for benefits, including compensation, attorney fees, costs, interest, reemployment or rehabilitation benefits, rehabilitation specialist or provider fees, or medical benefits under AS 23.30 that meet the requirements of (4) of this subsection; the claim may be filed on a form provided by the board: in this chapter, an application is a written claims;

(2) a petition is a written request for action by the board other than a claim that meets the requirements of (8) of this subsection; the petition may be filed on a form provided by the board;

(3) parties must be designated in accordance with 8 AAC 45.170;

(4) not later than 10 days after receiving a completed claim in accordance with this paragraph, the board or its designee will give notice that a claim has been filed by serving a copy of the claim by certified mail, return receipt requested, upon the employer or other person who may be an Interested party and, if the employer was not insured at the time of the injury, upon the Alaska Workers' Compensation Benefits Guaranty Fund; the board or its designee will not serve an incomplete claim and will return the incomplete claim to the claimant; a complete claim must include

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

(B) the signature of the claimant or a claimant's 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 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) for cases that 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 consolidated cases, the division will separate the case files, if appropriate, 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 the petitioner's representative and include the names and addresses of all parties, the date of injury, a description of the general nature of the dispute between the parties, and proof of service of the petition upon all parties; the board or its designee will not act on a petition that does not meet the requirements of this paragraph and will return an incomplete petition to the petitioner; a petition that alleges that a disability has ended or an impairment has become permanent must include

(A) the dates for which compensation was paid;

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

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

(D) a completed medical summary on Form 07-6103.

(c) For answers to claims and petitions under this subsection,

(1) an answer to a claim must be filed not later than 20 days after the date of service of the claim and served upon all parties; if an answer is not timely filed, default will not be entered, but statements in the claim will be deemed admitted; however, 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 not later than 20 days after the date of service of the petition and served upon all parties;

(3) an answer must be simple in form and language and state the admitted and disputed claims briefly and clearly 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 a hearing will be limited to those matters contained in the claim, petition, and answer, except as otherwise provided in this chapter;

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

(d) A reply is a response to an answer. No party is required to file a reply. A party who chooses to file a reply must file the reply not later than seven days after the answer was served upon the parties.

(e) 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) For stipulations under this subsection,

(1) a stipulation of facts signed by all parties may be filed if the parties agree that there is no dispute as to any material fact and agree to the dismissal of a filed claim or petition or the dismissal of a party; by filing a stipulation of facts under this paragraph, the parties agree to the immediate filing of an order based upon the stipulation of facts;

(2) stipulations between the parties may be made in writing at any time 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 named in 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 AS 23.30 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 boards;

(4) not with standing any stipulation to the contrary, the board may base its findings upon the facts as they appear from the evidence, may cause further evidence or testimony to be taken, or may order an investigation into the matter as prescribed by AS 23.30.

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; am 6/11/2023, Register 246, July 2023

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