Administrative Code Provisions | WCHR ยง 23-605-4 | 2018
(a) Any person who seeks compensation under this chapter shall file a written application with the commission on an official application form. All documents may be sent by mail, electronically transmitted or hand-carried to the commission office. The postmark or the date the electronic transmittal or hand-carried documents are received shall be deemed to be the date of filing.
(b) All applications and other documents must be typewritten, or legibly printed and signed in ink by the party submitting the same. In cases where documents have been electronically transmitted, an original signed application shall also be submitted. The original signature of the person signing the document or application constitutes a certification that the person read the document, and that to the best of the person's knowledge, information, and belief every statement contained in the document is true and no such statements are misleading.
(c) The commission may require statements of the facts surrounding the claim and may require certification of all supporting statements. The statements may include, among other things, information regarding recovery from other sources, amount of expenses incurred, dates of hospitalization or medical treatment and statements about the incident and such other information as the commission may request.