North Carolina Workers’ Compensation Form 33 is the document you file with the Industrial Commission to request that your disputed claim be assigned for a formal hearing. You can download it from the Commission’s website at ic.nc.gov. Attorneys must submit it through the Electronic Document Filing Portal (EDFP); unrepresented claimants can mail it to the Clerk’s Office in Raleigh. Filing moves your case out of an administrative stalemate and onto a track where a Deputy Commissioner will hear testimony and issue a binding decision.
When You File a Form 33
The most common trigger is a Form 61 denial from the insurance carrier. The denial form itself tells you that if you disagree, you may request a hearing by filing a Form 33.1North Carolina Industrial Commission. Form 61 – Denial of Workers’ Compensation Claim A full denial cuts off medical treatment and wage replacement immediately, so delay works against you.
Form 33 also covers disputes that fall short of a complete denial: refused surgeries or diagnostic tests, disagreements over your disability rating, fights about which doctor you can see, unpaid medical bills, contested average weekly wage calculations, and disputes over vocational rehabilitation.
If your employer carries no workers’ compensation insurance at all, the Commission’s FAQ instructs you to file a Form 18 and a Form 33 together.2North Carolina Industrial Commission. North Carolina Industrial Commission Frequently Asked Questions There’s no carrier to negotiate with, so you go straight to a hearing request.
Keep the two-year statute of limitations in mind. North Carolina bars the right to compensation unless a claim is filed with the Commission within two years after the accident, or within two years after the last payment of medical compensation when no other benefits have been paid.3North Carolina Industrial Commission. North Carolina General Statutes 97-24 – Right to Compensation Barred After Two Years That window governs getting your Form 18 on file. Once the claim exists and a dispute arises, don’t let the Form 33 sit; evidence and medical records get harder to pin down over time.
What You Need Before You Start
Form 33 is not the first document in a workers’ compensation case. You should already have a Form 18 (Notice of Accident to Employer and Claim of Employee) on file. The Commission describes Form 18 as “where you begin when you have a claim” and requires it to be filled out completely when you’ve been injured on the job.4North Carolina Industrial Commission. Workers Compensation Forms Processing that Form 18 generates the IC File Number you’ll put on your Form 33.
Pull the following together before you open the form:
- The IC File Number assigned to your claim.
- Full legal name, address, phone, and fax for both your employer and the insurance carrier.
- The exact date of injury, the body parts affected, and the city and county where the injury happened.
- Names and addresses of every doctor and lay witness you expect to call.
- A reasonable estimate of how long the hearing will take.
Having this in front of you prevents the kind of incomplete submission that gets kicked back by the Clerk’s Office.
Filling Out the Form
Form 33 is a single page, but the Commission’s rules require specific content in each section. Under 11 NCAC 23A .0602, a fully completed Form 33 satisfies the rule for requesting a hearing.5North Carolina Office of Administrative Hearings. 11 NCAC 23A – Workers’ Compensation Rules
Identification
The top of the form collects your full name, address, phone numbers, Social Security number, sex, and date of birth. Immediately below, enter your employer’s name, address, and phone, then the carrier’s name, address, phone, and fax. The IC File Number goes in the upper corner.6North Carolina Industrial Commission. Form 33 – Request That Claim Be Assigned for Hearing
Facts of the Claim
The middle section asks for the date of injury, body part injured, and the city and county where the injury occurred. You can request a different county for the hearing if the county of injury is inconvenient, but you have to explain why. The form then asks you to estimate hearing length; a half day is common for a straightforward case.
The Reason for the Request
This is the most important field on the form. The rule requires you to state the basis of the disagreement and the specific issues raised.5North Carolina Office of Administrative Hearings. 11 NCAC 23A – Workers’ Compensation Rules “Denied benefits” is not enough. Spell out what actually happened: the carrier denied the claim via Form 61 on a specific date, the carrier refuses to authorize a recommended surgery, you disagree with the disability rating assigned on a certain date. If you’re appealing an Administrative Order, include the order’s file date and the name of the hearing officer who issued it.6North Carolina Industrial Commission. Form 33 – Request That Claim Be Assigned for Hearing
Benefits Requested
Check the boxes that match what you’re asking for: compensation for missed work days (with the specific dates), medical expenses or treatment, permanent partial disability, permanent total disability, scarring. An “Other” box catches anything that doesn’t fit. The form also asks whether you’ve already participated in mediation; answer honestly, because the answer affects scheduling.
Witnesses and Service
List every witness you plan to call, including doctors, with their addresses. Sign and date. Then complete the certificate of service at the bottom, which records how and when you sent copies to the opposing parties.
How to File and Serve It
Filing method depends on representation. Attorneys must file through the Electronic Document Filing Portal at ic.nc.gov/docfiling.html.7North Carolina Industrial Commission. NC Industrial Commission Electronic Document Filing Portal The form itself directs attorneys to the portal.6North Carolina Industrial Commission. Form 33 – Request That Claim Be Assigned for Hearing The Commission’s Online Services Center also provides a direct link to file an electronic Form 33.8North Carolina Industrial Commission. Welcome to the Industrial Commission Online Services Center
If you’re representing yourself, mail the completed form to:
North Carolina Industrial Commission
Clerk’s Office
1236 Mail Service Center
Raleigh, NC 27699-12369North Carolina Industrial Commission. NC Industrial Commission Contact Information
However you file with the Commission, you also have to serve a copy on the opposing side: the employer’s attorney, or, if the employer is unrepresented, the employer and the carrier directly.5North Carolina Office of Administrative Hearings. 11 NCAC 23A – Workers’ Compensation Rules The certificate of service on the form is where you record this. Note the date served, the method (U.S. mail, email, fax, or hand delivery), and the name and address of each person served. The 45-day response clock begins when the opposing party receives your Form 33.
What Happens After You File
The Carrier’s Response
The employer or carrier has 45 days to file a Form 33R (Response to Request That Claim Be Assigned for Hearing).10North Carolina Industrial Commission. Rule 603 – Response to Request for Hearing Form 33R requires the defendant to state, with specificity, why the parties haven’t been able to agree.11North Carolina Industrial Commission. Response to Request That Claim Be Assigned for Hearing That response narrows the issues for mediation and hearing.
Mediation
North Carolina requires a mediated settlement conference before most workers’ compensation hearings. Within 55 days of your Form 33 filing, the parties should agree on a mediator. If they can’t, the Commission appoints one.12North Carolina Industrial Commission. NCIC Rules for Mediated Settlement and Neutral Evaluation During the same 55-day window, either party can move to skip or postpone mediation, though the Commission grants such requests sparingly.
Mediation puts both sides with a neutral mediator who tries to broker a settlement. Each side must send someone with actual settlement authority; the carrier cannot send a claims adjuster who needs to check with the home office.13Cornell Law Institute. 11 NC Administrative Code 23G 0104 – Duties of Parties Many cases resolve here. If mediation fails, the case moves to the hearing docket.
The Hearing
A Deputy Commissioner presides. The hearing functions like a trial: both sides present testimony, introduce medical records, and argue their positions. The Commission’s Uniform Pre-Trial Order requires parties to identify all expert witnesses, including independent medical examination doctors, and to complete their depositions within 60 days after the hearing.14North Carolina Industrial Commission. Uniform Pre-Trial Order Deposition transcripts are due within 30 days of each deposition. The time from filing Form 33 to receiving a hearing date varies with the Commission’s docket and the complexity of the case.
Discovery Opens Once You File
Filing Form 33 opens the door to formal discovery. Under Rule 605, you can serve interrogatories (written questions the other side must answer under oath) any time after filing a Form 33 and up to the hearing. Requests for production of documents have a tighter window; they must be served no later than 35 days before the hearing date.
Medical records drive most workers’ compensation cases. Under Rule 607(a), when a party requests medical, vocational, rehabilitation, or employment records, the other side has 30 days to produce them. That duty continues: any new records received after the initial exchange must be turned over within 15 days of receipt.
If the Decision Goes Against You
Either party can appeal a Deputy Commissioner’s decision to the Full Commission under N.C.G.S. 97-84 and 97-85. The Full Commission must render a decision within 60 days of the appeal filing.15North Carolina General Assembly. North Carolina General Statutes Chapter 97 – Workers Compensation Act It reviews the record independently rather than merely checking for error. From there, appeals go to the North Carolina Court of Appeals and, potentially, the North Carolina Supreme Court, which apply a narrower review focused on whether competent evidence supports the Commission’s findings and whether those findings support its legal conclusions.