Haw. Code R. § 23-604-6 - Applications and other documents

(a) Any eligible person who seeks compensation under this chapter shall file a written application on an official application form with the commission. The application may be sent by mail or hand-carried to the commission office. The postmark date shall be deemed to be the date of filing.

(b) The commission may require statements of the facts surrounding the claim and may require a certification of all supporting statements. The statements may include, among other things, information regarding recovery from other sources, amount of expenses incurred and dates of hospitalization or medical treatment.

(c) All applications for compensation shall be made within eighteen months after the date of injury, death or property damage. Upon a showing of good cause, the commission may consider applications beyond this time period. To establish "good cause" for the failure to timely file an application, an applicant must show by credible evidence that a mental, physical, or legal impairment, or actual or perceived fear, or threat, or coercion actually prevented filing within the required period. Good cause may not be established by ignorance of the law, incarceration, or negligent failure to ascertain the facts giving rise to a claim. Good cause applies to all claims for injuries or damages incurred after June 7, 1989, provided the commission may consider good cause for claims involving injuries resulting from sexual assault or sexual abuse suffered prior to June 7, 1989, if the victim was a minor at the time of the sexual assault or sexual abuse.

(d) All applications and other documents must be typewritten, or legibly printed and signed in ink by the party submitting the same. The 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.

(e) The commission may disregard any application or document which does not substantially conform with applicable rules as to required content and form, or is otherwise insufficient. If permitted, any amendment shall be effective as of the date of the original filing.

Notes

Haw. Code R. § 23-604-6

[Eff SEP 03 1994] (Auth: HRS § 351-68) (Imp: HRS § 351-68)