Forms Filing Update

Forms filing update

This email serves to notify stakeholders of proper procedures and future changes related to existing Board forms.

The Application for Reopening of a Claim, More than Seven Years after Accident (Form C-25) and Medical Proof of Change in Condition in Support of Application for Reopening (Form C-27) will be discontinued on July 3, 2023, and should no longer be submitted to the Board after this date.

After July 3, 2023:

Insurers seeking to reduce or suspend payment should file Application for Board Review (Form RB-89) requesting a rehearing/reopening if the request is due to a medical change in condition of the injured worker, or a loss of earnings not causally related to disability.

Parties may only file a Request for Further Action by Legal Counsel (Form RFA-1LC)Request for Assistance by Injured Worker (Form RFA-1W) or a Request for Further Action by Insurer/Employer (Form RFA-2) when:

  • reclassification is requested - such requests must be accompanied by supporting documentation showing a change in condition on Doctor's Report of MMI/Permanent Impairment (Form C-4.3).
  • the injured worker is eligible for Temporary Total Disability (TTD) after surgery.
  • the injured worker was paid reduced earnings and is seeking payment for any difference between actual and expected earnings.
  • a continuation of compensation payments has been directed at a tentative, TTD, or Temporary Partial Disability (TPD) rate, and the party seeks to change the rate or have it made permanent.
  • no continuation of compensation payments has been directed.

All other reopening requests on payment issues outside of these circumstances must be submitted through the Form RB-89

More information

If you have any questions, please contact the Board at (877) 632-4996.