Georgia’s workers’ compensation system uses many different forms published by the State Board of Workers’ Compensation. Insurance adjusters complete these forms to indicate that weekly benefits are starting or stopping or that claims are being denied. Attorneys file forms to request hearings or to file motions among other things. We previously wrote a series of blog articles about the most common types of workers’ compensation forms.
On 2/15/16, some of these forms will change. Changes are being made to the forms because of the introduction of the second version of the State Board’s Integrated Claims Management System (ICMS).
The State Board has used the first version of ICMS for many years. That first version made almost all Georgia workers’ compensation form filing electronic. It allowed attorneys to have easier and instant access to their clients’ State Board files. This access allowed us to better represent our clients.
Hopefully, the second version of ICMS known as ICMS II will make even more improvements. The State Board has announced that the following changes will be made to make forms compatible with the new ICMS II.
- WC-6 – Wage Statement- This form has been amended to add another box in section C for “no off days.”
- WC-14- Notice of Claim/Request for Hearing/Request for Mediation- This form has been amended to add a box for description of accident, dependency benefits and burial expenses. The form has also been changed so that the insurer information no longer includes the claims office when an initial WC-14 is filed. The claims office will be added by the filing of a WC-1. “Multiple body parts” has been removed as a selection for “Part of Body Injured,” and more than one body part may now be selected.
- WC-14a-Request to Change Information on a Previously Filed WC-14-This form has been amended to allow information previously filed on a WC-14 to be corrected. The following information can be changed on this form: the date of injury (plus or minus 30 days from the date of injury on the WC-14), correction of a party name, dismissal of an employer, insurer/self-insured employer or claims office. Hearing issues may also be added on this form.
- WC-20a – Medical Report- This form has been amended to update the box in number 6 from ICD-9 code to ICD-10 code.
- WC-25 – Application for Lump Sum/Advance Payment- This form has been streamlined and made more user-friendly. Sections B thru F have been changed to provide for better organization of the information requested.
- WC-100 – Request for Settlement Mediation-This form was amended to remove the former Section B – “Settlement Request information,” and make Section B the “Certification” section.
- WC- Request To Change Information – New form – This form was created to correct the employee’s name, SSN or Board Tracking #, correct the county of injury and to correct a claims office that has been listed incorrectly in the claim.
- WC-Change of Address- This form was amended to allow the filing of the form online to correct the address of the employee/claimant, employer, attorney, and other party – insurer, self-insurer, claims office and party at interest.
- WC-R1 – Request for Rehabilitation-This form was amended to remove the catastrophic injury box in Section 1.
- WC-R1CATEE – This form was amended to add “prior to injury” after 15 years in Section 3.
- WC-Rehab Objection – This form was amended to change the order of the boxes listed in Section B to the following:
- 1. WC-R1
- 2. WC-R1CATEE
- 3. WC-R2
- 4. WC-R2a
- 5. WC-R3
All of us hope that the transition to the new version of ICMS is a smooth one.
