2951.1 Appeals shall be initiated by filing a written hearing request at OAH. The request shall be made on a form supplied by the Public Sector Workers’ Compensation Program (the Program) and approved by OAH. A hearing request must contain:

1. (a) The name, address, and email address of the claimant and of the claimant's representative, if any;
2. (b) The type of claim;
3. (c) Claimant's employing agency when the injury occurred;
4. (d) A statement that the person signing the hearing request has read it and attests that the contents are true and accurate to the best of his or her knowledge;
5. (e) The signature of the claimant or the claimant's representative, if any;
6. (f) If the hearing request is an appeal of a decision made by the Program in accordance with D.C. Official Code §§ 1-623.24(b) or 1-623.24(d), the request must also contain:
7. i. A statement identifying the date and nature of the decision being appealed;
8. ii. The reason(s) why the claimant considers the decision to be incorrect;
9. iii. A detailed statement of facts in support of each reason; and
10. iv. The specific nature and extent of the relief sought.
11. (g) If the hearing request is to determine whether the claimant is entitled to permanent disability scheduled awards under D.C. Official Code §1-623.07(c), requested in accordance with D.C. Official Code §1-623.06a, the request must contain:
12. i. A claimant's request for the Program to schedule a physician evaluation of claimant's Maximum Medical Improvement (MMI) status; or
13. ii. A physician's medical report that identifies the clinical diagnosis, diagnosis code, current clinical symptoms, current examination findings, MMI date, diagnostic test results, medical records reviewed, and explains how the physician arrived at the impairment

rating, citing to the specific page number paragraph, and table relied upon within the AMA guides applied; or

iii. If supporting medical evidence, records, or reports are not available at the time of filing a hearing request, the request should include a physician's certification of that fact.

2951.2 A hearing request must be accompanied by a copy of the decision being appealed or a copy of the Notice of Benefits Expiration if one has been issued.

2951.3 The claimant or claimant's representative shall sign the request for hearing and file it with OAH within thirty (30) days of service of the decision or within the last fifty-two (52) weeks of a Claimant's receipt of five hundred (500)-weeks of TTD benefits for permanent disability hearing requests. OAH Rule 2809 prescribes procedures for filing.

2951.4 No hearing request shall exceed forty (40) pages, exclusive of the cover page. The Clerk may reject hearing requests that do not conform to these rules.

2951.5 The presiding Administrative Law Judge may excuse a Claimant's failure to comply with the specific requirements of this section.

SOURCE: Final Rulemaking published at 64 DCR 6616 (July 14, 2017); as amended by Final Rulemaking published at 68 DCR 010559 (October 8, 2021).