Request That Claim Be Assigned For Hearing {33}

FORM 33 - REQUEST THAT CLAIM BE ASSIGNED FOR HEARING. This form is used in North Carolina workers’ compensation cases to request that a disputed claim be scheduled for a hearing before the North Carolina Industrial Commission. Form 33 is filed when the employee and employer (or insurance carrier) cannot reach an agreement on compensation or when a party is appealing an administrative decision. The form identifies the parties, injury details, insurance information, and the specific benefits being disputed, such as wage replacement, medical treatment, or disability compensation. It also requires the requesting party to explain the reason for the dispute, list anticipated witnesses, and certify that the case is ready for hearing. Form 33 must be filed with the Commission and served on all opposing parties. www.FormsWorkflow.com