1. (a) A claim for compensation for benefits for an injury, including a cumulative trauma injury and death, or occupational disease or illness, occurring on or after February 1, 2014, shall be commenced by filingan executed notice form with the Commission that includes the employer's Federal Employer Identification Number and the worker's full name and date of birth, mailing and e-mail address, and the last five digits of the worker's Social Security number. The following forms, or electronic equivalents, shall be used as appropriate:

   1. (1) CC-Form-3 claim for compensation for benefits for a single event or cumulative trauma injury;
   2. (2) CC-Form-3A claim for compensation for death benefits; and
   3. (3) CC-Form-3B claim for compensation for occupational disease or illness benefits.
2. (b) A proceeding under 810:15-15-3 to address payment of disputed fees for health services (e.g. physician fees, hospital costs, etc.), vocational rehabilitation or medical case management, shall be commenced by filing an MFDR Form 19 or electronic equivalent. A CC-Form-9 or electronic equivalent shall be filed to request a hearing on an MFDR Form 19 dispute.
3. (c) Within ten (10) days of the filing of a claim for compensation (i.e. CC-Form-3, CC-Form-3A or CC-Form-3B), the Commission shall mail or send electronically a copy of the claim form bearing the assigned file number to the service agent designated by the self-insured employer, group self-insurance association, or insurance carrier, or as otherwise directed in that Section.

Added at 31 Ok Reg 468, eff 2-4-14 (emergency)

Added at 32 Ok Reg 1461, eff 8-27-15

Amended at 35 Ok Reg 2303, eff 9-14-18

Amended at 37 Ok Reg 2335, eff 9-11-20

Amended at 42 Ok Reg, Number 21, effective 8-1-25