Request For Hearing {IC9}

IC9 - REQUEST FOR HEARING. This form is used by the Illinois Workers’ Compensation Commission to formally request a hearing before an arbitrator in a workers’ compensation or occupational disease case. It is completed jointly or separately by the petitioner (employee) and respondent (employer) to confirm they are prepared to proceed to trial on a scheduled date, unless otherwise approved by the arbitrator. The form documents agreements or disputes between the parties on key issues, such as the existence of an employment relationship, occurrence and cause of the injury or occupational disease, notice of the accident, wage calculations, medical bills, temporary disability periods, and benefits paid. It also addresses liability for unpaid medical expenses, entitlement to penalties or attorney’s fees, and any other unresolved matters. The form requires signatures from the parties or their attorneys, contact information, and insurance details, and it serves as an official record to move the case forward to arbitration. www.FormsWorkflow.com