What Is A Form 33R in Workers’ Compensation?

When an employee files a Workers’ Compensation claim, there is a chance the claim can be denied. If it is denied, the employee or their medical provider can request a hearing with the Industrial Commission. To do this, they must fill out and submit either a Form 33 (Request that Claim Be Assigned for Hearing) or a Form 33I (Intervenor’s Request That Claim Be Assigned for Hearing). Within 45 days of receiving either of these two forms a Form 33R (Response To Request That Claim Be Assigned For Hearing) must be filed. The original form must be sent to the Industrial Commission and copies must be sent to all parties involved in the case.

Form 33R is to be filled out by the self-insured employee, insurance carrier or counsel for the defendant. This form must include a statement that explains the basis of the disagreement between the parties, including specific issues that are accepted or denied by either party. The date of the injury, the body part that was injured, and the city and county where the injury occurred must also be included on this form. This form also has a place to list the names and addresses of all witnesses who will need to testify at the hearing. When a hearing date is set, the subpoenas for these witnesses should be sent to the person who filed out Form 33R and that person will get them to the Sheriff’s office so that they can be delivered to the witnesses.