Last updated: 10/1/2025
Election To Either Receive Reemployment Benefits Or A Job Dislocation Benefit {07-6153}
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Description
Form 07-6153 - ELECTION TO RECEIVE EITHER: REEMPLOYMENT BENEFITS OR JOB DISLOCATION BENEFIT. This The Alaska Division of Workers’ Compensation form lets injured workers (injuries on/after 1/1/2025) choose reemployment benefits or a job dislocation benefit and waive the other within 30 days of eligibility notice (AS 23.30.041(g)). Reemployment benefits are RBA-overseen, include selection of a qualified rehabilitation specialist, and provide a plan (cost cap $22,150, max 2 years) with wage-replacement (TTD → PPI at TTD rate → 70% spendable wage). The alternative job dislocation option pays a lump sum of $5,000 / $8,000 / $13,500 based on the PPI rating, in addition to PPI. The election must be notarized, filed with the Division, and becomes irrevocable once served on the RBA and insurer. www.FormsWorkflow.com
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