Procedure for dispute resolution

1. An injured employee may contact the office for assistance at any time. The injured employee shall contact the office to request assistance with a dispute arising from an order within forty- five days of the date of service of the order. An injured employee shall make an initial request in writing for assistance with an order. 2. In an attempt to resolve the dispute, the decision review specialist may contact any interested parties. After oral or written contact has been made with the appropriate interested parties, the decision review specialist will attempt to accomplish a mutually agreeable resolution of the dispute between the organization and the injured employee. The decision review specialist may facilitate the discussion of the dispute but may not modify a decision issued by the organization. 3. If an injured employee has attempted to resolve the dispute and an agreement cannot be reached, the decision review specialist shall issue a certificate of completion. The decision review specialist will issue the certificate of completion to the injured employee by regular mail or electronic means and will inform the injured employee of the right to pursue the dispute through hearing. To pursue a formal rehearing of the claim, the injured employee shall file a request for rehearing with the organization's legal department within forty-five days after the certificate of completion is issued. 4. If an injured employee has not attempted to resolve the dispute, the office shall notify the injured employee by letter, sent by regular mail, or electronic means, of the injured employee's nonparticipation in the office and that no attorney's fees shall be paid by workforce safety and insurance should the injured employee prevail in subsequent litigation. The decision review specialist shall inform the injured employee of the right to pursue the dispute through hearing. To pursue a formal rehearing of the claim, the injured employee shall file a request for rehearing with the organization's legal department within forty-five days after the letter of noncompliance is issued. 5. If an agreement is reached, the organization must be notified and an order or other legal document drafted based upon the agreement. 6. The office will complete action within thirty days from the date that the office receives an injured employee's request for assistance. This time frame may be extended if the decision review specialist is in the process of obtaining additional information.