Form AR-P Ark. Code Ann. §11-9-403, 407 AWCC Rule7 Updated: 04-15-02 ARKANSAS WORKERS’ COMPENSATION COMMISSION 324 Spring Street, Little Rock, AR 72201 Mail: P. O. Box 950, Little Rock, AR 72203-0950 Little Rock Office - 1-800-622-4472 / 501-682-3930 Ft. Smith Office - 1-800-354-2711/ 479-783-7970 Springdale Office - 1-800-852-5376 / 479-751-2790 P WORKERS’ COMPENSATION INSTRUCTIONS TO EMPLOYERS AND EMPLOYEES All employees of this establishment entitled to benefits under the provisions of the Arkansas workers’ compensation laws are hereby notified that their employer has secured the payment of such compensation as may at any time be due employees or their dependents. This employer is required by state law to provide workers’ compensation coverage or this employer has waived the exclusion or exemption from the operation of the workers’ compensation laws, and the employer certifies by the display of this poster that workers’ compensation coverage is now provided by a workers’ compensation insurance policy or by enrollment in the Arkansas Self-Insurance Program or by the Public Employee Claims Division of the Arkansas Insurance Department. (Place label indicating Insurer’s Name, Claims Office Address, Claims Office Phone Number and Policy Expiration Date) IN CASE OF JOB-RELATED INJURIES OR OCCUPATIONAL DISEASES The Employer Shall: 1. 2. 3. 4. Provide all necessary medical, surgical and hospital treatment, as required by law, following the injury and for such additional time as ordered by the W orkers’ Compensation Comm ission. Provide comp ensation paym ents in accordance with the provisions of the law. The first installment of compensation becomes due on the 15 th day after the employer has notice of the injury or death, except in those cases where liability has been denied by the employer. Pro vide p rompt rep orting o f accidents to appropriate parties. Keep a reco rd of all injuries received b y its employees. The Employee Shall: The employee shall report the injury to the employer on Form N and to a person or at a place specified by the employer, unless the injury either renders the employe e phys ically or mentally unable to do so, or the injury is made known to the employer immediately after it occ urs. T he em ployer shall not be responsible for disability, medical, or other benefits prior to receipt of the employee’s notice of injury. All reporting procedures specified by the employer must be reasonable and shall afford each employee reasonable notice of the reporting requirements. The foregoing shall not apply when an employee requires emergency medical treatment outside the employer’s normal business hours; however, in that event, the emp loyee sh all cause a report of the injury to b e made to the employer on the emp loyer’s ne xt regular business day. Failure to give such notice shall not bar any claim (1) if the employer had knowledge of the injury or death, (2) if the employee had no knowledge that the condition or disease arose out of and in the course of employment, or (3) if the Commission excuses such failure on the grounds that for some satisfactory reason such notice could not be given. Objection to failure to give notice must be made at or before the first hearing on the claim. Statutory Information: Ark. Code Ann. § 11-9-514(b) states: “Treatment or services furnished or prescribed by any physician other than the ones selected acc ording to the forego ing, except em ergency treatm ent, shall be at the claimant’s expense.” Ark. Code A nn. § 11-9-514(f), howe ver, indicates: W hen co mpe nsability is controverted , subsection (b ) shall not apply if: (1) The emp loyee requests medical assistance in writing prior to seeking the sam e as a result of an alleged com pensable injury; and (2) The employer refuses to refer the employee to a medical provider within forty-eight (48) hours after such written request as provided above; and (3) The alleged injury is later found to be a com pensable injury; and (4) The employer has no t made a previous offer of medical treatm ent. If you have any questions regarding your rights under the Arkansas workers’ compensation laws, you may call an Arkansas W orkers’ Compensation Commission legal advisor at our toll-free number listed above. All employers who com e within the operation o f the Arkansas w orkers’ com pensation laws and have c omp lied with its provisions must post this notice in a CON SPICUOU S place in or about their place or places of business. P American LegalNet, Inc. www.FormsWorkflow.com AWCC Form P (Posting Notice) A posting notice is mentioned in Ark. Code Ann. §11-9-403, Ark. Code Ann. §11-9-407 and AWCC Rule 7. AWCC Form P satisfies all requirements. Form P: 1. Is to be on display in a conspicuous place; 2. Tells employers what to do when an employee is injured; 3. Instructs employees to notify the employer immediately (or no later than the close of the next business day) when injured; 4. Lists the claims office that will be handling the insurance aspects of the case; 5. Gives the claims office telephone number; 6. Announces the expiration date of the insurance policy; and 7. Provides telephone numbers for Arkansas Workers' Compensation Commission legal advisors if either party needs assistance. Employers without Form P may lose the use of Form N as a defense in litigation. Employees disobeying instructions on Form P may delay their benefits or jeopardize the awarding of any benefits in a contested case. The AWCC furnishes samples, not supplies, of Form P. Carriers are to send their insureds an adequate number, and self-insureds must arrange with a printer for the supply they need. Carriers and employers may enlarge Form P for posting purposes. Information about Form P is available from the Support Services Division (1-800-622-4472 or 501-6823930). Ark. Code Ann. §11-9-106(a): “Any person or entity who willfully and knowingly makes any material false statement or representation, who willfully and knowingly omits or conceals any material information, or who willfully and knowingly employs any device, scheme, or artifice for the purpose of: obtaining any benefit or payment; defeating or wrongfully increasing or wrongfully decreasing any claim for benefit or payment; or obtaining or avoiding workers’ compensation coverage or avoiding payment of the proper insurance premium, or who aids and abets for any of said purposes, under this chapter shall be guilty of a Class D felony. Fifty percent (50%) of any criminal fine imposed and collected under .... this section shall be paid and allocated in accordance with applicable law to the Death and Permanent Total Disability Trust Fund administered by the Workers’ Compensation Commission.” American LegalNet, Inc. www.FormsWorkflow.com