When Should You File Form 33 in North Carolina?

A workers’ compensation claim does not always shift from accepted to disputed with an obvious denial letter. Sometimes the change is less clear: provisional payments end, a recommended treatment is not authorized, or another disagreement develops over benefits. Recognizing that a dispute has started is the first step toward determining what needs to happen next.

Form 33 is used to formally request that an unresolved workers’ compensation dispute be assigned for hearing before the North Carolina Industrial Commission. Knowing when that step is appropriate, and when another response may be required first, is something a Charlotte workers’ compensation lawyer can evaluate based on the status of the claim and the issue being disputed.

What Form 33 Actually Does

Form 33, officially titled Request That Claim Be Assigned for Hearing, is the formal mechanism for putting an unresolved workers’ compensation dispute before the North Carolina Industrial Commission. Filing it does not resolve the dispute itself. Instead, it places the case on the hearing track, which generally includes mediation before the case proceeds to a formal hearing.

Understanding when Form 33 may be appropriate requires understanding a few of the forms that can come earlier in a claim, since disputes often develop after a carrier accepts, denies, or begins paying a claim without prejudice.

The Forms That Come Before Form 33: Form 60, 61, and 63

Once a claim is reported, the employer or insurance carrier may use several different forms to indicate how the claim is being handled. Understanding these forms can help explain why a dispute developed and whether requesting a hearing through Form 33 may eventually become necessary.

• Form 60 — Acceptance of the Claim: A Form 60 accepts the employee’s right to compensation for the injury or occupational disease identified on the form and provides information about the benefits being paid.
• Form 61 — Denial of the Claim: A Form 61 notifies the worker that the employer or carrier is denying the claim. The form must state the grounds for the denial rather than simply saying that the claim was rejected.
• Form 63 — Payment Without Prejudice: A Form 63 allows the carrier to begin paying benefits without formally accepting liability while it continues investigating the claim. This payment-without-prejudice period generally lasts up to 90 days.

Form 63 can also be used to provide medical compensation only without admitting liability for the claim. Because Form 63 can be used in different ways, workers should look at which option is selected on the form rather than assuming that receiving benefits means the claim has been formally accepted.

When to File Form 33

The most straightforward scenario for filing Form 33 workers’ compensation requests is a formal denial. Once a worker receives a Form 61, they have two years from either the injury date or the denial date to file Form 33 and contest it. This deadline is worth treating as firm rather than flexible, since missing it can foreclose the ability to challenge the denial at all.

When to File Form 33 After a Form 63 Dispute

A Form 63 allows the employer or carrier to begin paying benefits without admitting liability while it investigates the claim. For indemnity benefits paid without prejudice, that period is generally limited to 90 days, although the Industrial Commission may allow an extension in certain circumstances. If the carrier does not contest the claim within the applicable period, the claim may become accepted by operation of law.

A dispute can still develop over what happens during or after that period. For example, the carrier may deny the claim before the payment-without-prejudice period expires, or disagreements may arise over continued benefits or medical treatment. If the carrier stops paying benefits or otherwise disputes what the worker is entitled to receive, filing Form 33 may be appropriate to put the unresolved issue before the Industrial Commission.

When to File Form 33 Over a Benefits Dispute on an Accepted Claim

Filing Form 33 is not limited to claims that were denied outright. A claim can be accepted through a Form 60 and still generate a dispute later over issues such as a permanent impairment rating, whether additional medical treatment should be authorized, or how the worker’s average weekly wage was calculated. Form 33 can be used to request a hearing when those disputes cannot be resolved between the parties.

A Form 24 requires a somewhat different response. When an employer or carrier files Form 24 seeking permission to terminate or suspend ongoing compensation, the worker has an opportunity to object to that application through the Industrial Commission’s Form 24 process. Depending on the circumstances and whether other disputed issues remain, a Form 33 may also become appropriate, but it is not a substitute for responding to the Form 24 itself.

What Filing Form 33 Actually Requires

A Form 33 is not simply a form expressing disagreement. The person requesting the hearing must identify the reasons the parties have been unable to agree, the benefits being sought, and the witnesses they expect to call. Providing enough information to clearly identify the dispute helps establish what issues will need to be addressed as the case moves toward mediation and, if necessary, a hearing.

There is also an important requirement when a claim has been denied. A Form 61 must state the grounds for the denial in sufficient detail to allow the worker to understand why the claim was rejected. If the stated reason is unclear or insufficient, that may need to be addressed as part of challenging the denial rather than simply accepting a vague explanation as the carrier’s final position.

What Happens After Filing Form 33

After Form 33 is filed, the opposing party generally files a Form 33R, Response to Request That Claim Be Assigned for Hearing. The response identifies the issues the responding party believes are in dispute and the witnesses it expects to call. The case is then generally referred to mediation before proceeding to a formal hearing before a Deputy Commissioner.

Mediation gives both sides an opportunity to resolve the dispute without a hearing. If they cannot reach an agreement, the case can continue through the Industrial Commission’s hearing process. Clearly identifying the disputed issues on Form 33 helps establish what needs to be addressed during mediation and, if the case does not settle, at the hearing.

Knowing When Form 33 Is the Right Step

A formal denial is one of the clearest reasons a worker may need to request a hearing, but it is not the only one. Disputes can also develop in accepted claims over medical treatment, wage calculations, disability benefits, or other issues. A claim being paid without prejudice under Form 63 can also develop into a dispute that requires further action.

The important question is whether there is an unresolved issue that needs to be decided by the Industrial Commission. Form 33 places that dispute on the hearing track, but other procedures may apply depending on the specific issue involved. Understanding what is being disputed and what response North Carolina’s workers’ compensation system requires can help determine whether filing Form 33 is the appropriate next step.

If a dispute has developed in your workers’ compensation claim, Waple & Houk can review how the claim is currently being handled and determine what steps may be needed to protect your right to benefits.