Petition For Reconsideration Of Application For Self-Insurance {IC51}

IC51 - PETITION FOR RECONSIDERATION OF APPLICATION FOR SELF-INSURANCE. This form is used by an employer or entity to request that the Chairman of the Commission reconsider the conditional approval or denial of its initial or renewal application for self-insurance. This form allows the employer to explain in writing the reasons why the decision should be reconsidered and to submit supporting documentation, including new or previously unavailable information such as evidence of improved financial condition. The employer may also request a hearing on the petition, during which they can present evidence, call or cross-examine witnesses, and respond to the Commission’s findings. If no hearing is requested, the Chairman will review the petition and accompanying documentation before making a final determination. The Chairman’s decision will then be issued in writing, with the option for the employer to seek further review through the appeals process. www.FormsWorkflow.com