Hawaii Administrative Rules
Title 12 - DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
Chapter 10 - WORKERS COMPENSATION
Subchapter 2 - COMPENSATION
Section 12-10-30 - Documentation of claims

Universal Citation: HI Admin Rules 12-10-30

Current through August, 2024

(a) If an employer denies compensability of a claim and the employee disagrees, the employee shall file form WC-5 which shall be provided to the employee by the department. The WC-5 shall authorize the release of medical documents pertaining to or having a bearing on the injury.

(b) If an employer fails to file form WC-1 and the employee wishes to pursue a claim, the employee shall file form WC-5 which shall be provided by the department.

(c) If a dependent of a deceased claimant wishes to pursue a claim, the dependent shall file form WC-5a, which shall be provided by the department. The WC-5a shall authorize the release of medical documents pertaining to or having a bearing on the injury.

(d) Any request for reopening of any claim pursuant to section 386-89(c), HRS, shall be accompanied by medical information or any other substantial evidence showing a change in or of a mistake in a determination of fact related to the physical condition of the injured employee.

Disclaimer: These regulations may not be the most recent version. Hawaii may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.