North Carolina Industrial Commission Form 33, titled “Request That Claim Be Assigned for Hearing,” is the document an injured worker, employer, or attorney files to ask the Commission to set a workers’ compensation dispute for a hearing before a Deputy Commissioner. You file it when the two sides cannot agree on benefits, medical care, or whether the injury is even covered. The form is short, but the words you put in it shape your entire case, and a vague or incomplete answer can stall your claim for months.
This is the form that turns a stuck claim into a live court case. If your benefits were denied, cut off, or never started, Form 33 is how you force a decision from a neutral judge. About 60,000 to 75,000 new injury claims are reported to the North Carolina Industrial Commission each year, and a large share of the contested ones move forward only after a Form 33 is filed. Getting this one page right matters more than most people expect.
Here is what you will learn in this guide:
- 📋 What Form 33 does, who must file it, and the law that controls it
- 🗂️ The exact documents and details to gather before you start
- ✍️ A line-by-line walkthrough of every box, using the verbatim field names from the official form
- 👥 Three real-world filing examples you can follow start to finish
- ⚠️ The field-level mistakes that get claims delayed or dismissed, and how to dodge them
What the Form Is and Who Must File It
Form 33 is the official request that asks the North Carolina Industrial Commission to assign a workers’ compensation claim for a contested hearing. You can download the current printable Form 33 PDF directly from the Commission, and the version you want carries the revision date 04/2023 printed in the bottom corner. The Commission also offers a fillable “Electronic Form 33” on its official forms page, and both versions ask for the same information.
The form exists because the workers’ compensation system runs on agreement first and litigation second. When you and the insurance carrier agree, you sign settlement forms and never see a judge. When you cannot agree, N.C. Gen. Stat. § 97-83 gives you the right to ask the Commission to step in and decide the dispute, and Form 33 is the vehicle that does it. Ignoring this statute means your dispute simply sits unresolved, because no judge acts until someone files.
Three groups file Form 33: the Employee (the injured worker), the Employer, and the Attorney for either side. Most filers are injured workers whose claims were denied or whose benefits stopped, and many file without a lawyer. An employer or carrier can also file, often to force a worker back to work or to end ongoing payments. A common misconception is that only the injured person can request a hearing, but the form clearly lets a defendant request one too.
Filing Form 33 starts a clock for the other side. Within 45 days of receiving the Form 33, the opposing party must file a Form 33R, the formal response that states their defenses. Once both are in, the case moves toward mandatory mediation and then a hearing. The Commission processes thousands of these requests a year, so a clean, specific Form 33 helps your case move faster than a sloppy one.
Before You Start: Documents and Information You Need
Filling out Form 33 goes faster and cleaner when you gather your facts first. The form asks for names, addresses, dates, and a clear statement of why you cannot agree, so missing details force you to guess, and guessing creates errors that delay your hearing. Pull these items together before you open the form.
- Your full legal name and current mailing address. The Commission mails hearing notices and subpoenas here, so an old address means you miss critical deadlines.
- Your Social Security number. Disclosure is voluntary, but it helps the Commission verify your employer and find the correct insurance coverage, which speeds processing.
- Your date of birth and sex. These confirm your identity against existing claim records and prevent the file from being matched to the wrong person.
- Your employer’s exact legal name and address. A wrong or “doing business as” name can attach your request to the wrong company and stall service.
- The insurance carrier’s name, address, and phone number. The carrier is the party you are fighting, and the Commission needs it to serve your request.
- Your IC File Number. This number ties your hearing request to your existing claim, and leaving it blank can create a duplicate file.
- The date of injury and the part of the body hurt. These anchor the claim and must match your earlier Form 18 and medical records.
- The city and county where the injury happened. The Commission sets your hearing in that county by default, so this controls where you travel.
- A specific written reason you cannot agree. This is the heart of the form, and a vague reason invites a motion to dismiss or a delay.
- Names and addresses of your witnesses and doctors. The Commission issues subpoenas from this list, and a missing doctor address means no subpoena gets issued.
Gathering these first also tells you whether you still have time. Under N.C. Gen. Stat. § 97-24, you generally must file a claim within two years of the injury, and missing that window can end your right to benefits before you ever reach a hearing.
Where to Get the Form and How to Access It
The safest place to get Form 33 is the North Carolina Industrial Commission itself, never a random third-party site that may host an outdated version. Download the official printable Form 33 or use the fillable Electronic Form 33 linked on the Commission’s forms page. A Spanish-language Form 33 is also available for filers who prefer it.
You have two ways to complete the form. The printable PDF lets you type or hand-print your answers, then print, sign, and file the result, which works well for filers who like paper. The Electronic Form 33 walks you through the same fields on screen and is built for the Commission’s filing portal, which reduces typos and missing boxes.
The form looks deceptively simple at two pages, so do not let its length fool you. Page 1 collects identifying details and your reason for the hearing, and page 2 lists your witnesses, your signature, and the Certificate of Service. If you cannot print or download, you can request a copy by phone through the Commission Helpline at (800) 688-8349.
A common misconception is that you need a special account or a lawyer’s login just to get the form, but the blank form is free and public. Attorneys must file through the Electronic Document Filing Portal, while self-represented employees may also use email, fax, or mail. Always confirm the 04/2023 revision date in the corner so you are not filing a retired version that the Commission could reject.
Step-by-Step: How to Fill Out Form 33 Line by Line
This is the core of the form, and every box matters. Work through the fields in the order they appear on the official 04/2023 version, and use the exact field names printed on the form. Each entry below tells you what the box asks, how to answer, an example, a tricky edge case, the mistake to avoid, and a false belief to drop.
IC File
This box asks for the Industrial Commission file number already assigned to your claim. Write the number in the top-right corner exactly as it appears on prior letters or forms from the Commission, usually a string like W12345678 or a similar code. For example, Tasha Greene copies 21-987654 from the denial letter she received from the carrier.
If you never received a file number because no Form 18 was filed yet, leave it blank and the Commission will assign one. The most common mistake here is inventing or guessing a number, which can attach your hearing request to a stranger’s claim and create a tangled duplicate file. Many filers believe a blank file number voids the form, but the Commission can still open a new file from your details, so an honest blank beats a wrong guess.
Employee’s Name (Last Name, First Name)
This field asks for the injured worker’s full legal name. Print your last name and first name in the order the form shows, using the name on your Social Security card and not a nickname. For example, Rodriguez, Carlos writes his surname first, then his given name.
If your name changed after marriage or divorce, use the name that matches your current employment and medical records, and note the prior name in the “Other” reason line if it helps avoid confusion. The frequent mistake is entering a nickname like Charlie instead of Carlos, which makes it harder for the Commission to match you to your existing claim. Some filers think the name must match their driver’s license, but the controlling document is the name your employer and the carrier already have on file.
Employee’s Address, City, State, Zip
This block asks where the Commission and the other parties should mail documents to you. Enter your current street address, city, state, and ZIP code where you actually receive mail. For example, Carlos Rodriguez writes 4120 Maple Ridge Dr, Durham, NC 27704.
If you use a P.O. Box, you can list it here, but add a physical address too if hand delivery of a subpoena might be needed. The biggest mistake is listing an old address, because hearing notices and subpoenas go here, and a missed notice can lead the Commission to dismiss your request for failure to prosecute. People often assume the Commission will track them down by phone or email, but official notices travel by mail, so a wrong address can quietly sink your case.
Telephone Number, Home Telephone, Work Telephone
These fields ask for the phone numbers where the Commission or opposing counsel can reach you. Write a current number in each box that applies, including the area code in the parentheses provided. For example, Carlos enters (919) 555-0148 as his home telephone and leaves the work telephone blank because he is out of work.
If you only have a cell phone, list it as the home telephone so there is at least one working contact. The common mistake is leaving every phone box blank, which slows mediation scheduling because the mediator cannot reach you. Filers sometimes think phone numbers are optional fluff, but the mediator often calls to set the conference, and no number means more delay.
Social Security Number
This box asks for the worker’s Social Security number so the Commission can verify the employer and locate insurance coverage. Disclosure is voluntary, but providing it speeds the matching process, so most filers enter it as 123-45-6789. The form’s own disclosure statement, based on N.C. Gen. Stat. § 132-1.10, promises the number stays confidential and exempt from public disclosure.
If you are uneasy about privacy, you may leave it blank, since the law makes disclosure optional, though verification may take longer. The mistake to avoid is transposing digits, which can point the Commission to the wrong employer and delay coverage verification. Many people believe the number becomes public record on a filed form, but the Commission shields it under the statute, so the privacy fear is largely misplaced.
Sex and Date of Birth
This field asks you to mark M or F and to write your date of birth. Check the correct box and enter the date in month, day, year order in the slashes provided. For example, Carlos checks M and writes 07/19/1986.
If your records show a different birth date because of a past clerical error, use the date your medical and employment records show so everything matches. The mistake here is reversing the month and day, which can mismatch you against your claim file. Some filers skip this as trivial, but the Commission uses birth date plus name to confirm identity, so an error here slows the match.
Employer’s Name, Address, City, State, Zip
This block asks for the legal name and address of the company you worked for when you got hurt. Enter the employer’s exact legal name, not a store nickname, along with the full address. For example, Carlos writes Piedmont Logistics LLC, 88 Industrial Pkwy, Greensboro, NC 27401.
If your worksite differs from the corporate headquarters, list the location where you worked and add the corporate name if you know it. The common mistake is writing a “doing business as” trade name instead of the legal entity, which can route your request to the wrong company and delay service. Filers often assume the Commission already knows the employer, but the form is how the Commission and carrier confirm the right defendant.
Insurance Carrier, Carrier’s Address, Carrier’s Telephone Number, Fax Number
This field asks for the workers’ compensation insurance company handling your claim, plus its address and phone and fax numbers. Copy the carrier name and contact details from any denial letter, EOB, or prior correspondence. For example, Carlos enters Sentinel Casualty Insurance Co., 500 Corporate Center Dr, Raleigh, NC 27607, (800) 555-0199.
If your employer is self-insured or you cannot find a carrier, write Unknown and let the Commission verify coverage using your Social Security number. The mistake to avoid is naming the third-party administrator instead of the actual carrier, which can confuse who must respond. People often think the employer’s own insurance agent is the carrier, but the claims-handling carrier is the party that must answer your Form 33.
Date of Injury
This box asks for the exact date you were hurt or, for an occupational disease, the date of diagnosis or last exposure. Write it in month, day, year order, matching your Form 18 and medical records. For example, Carlos writes 03/04/2025.
If your injury built up over time, like carpal tunnel, use the date a doctor connected the condition to your job. The common mistake is guessing a date that conflicts with your earlier filings, which hands the carrier a defense that your claim is untimely. Filers sometimes believe an approximate month is fine, but a precise date protects you against statute-of-limitations arguments under N.C. Gen. Stat. § 97-24.
Part of Body
This field asks which part of your body was injured. List every body part affected, not just the worst one, using plain terms. For example, Carlos writes Lower back and right shoulder.
If your injury later spread to a new area, like a back injury causing leg numbness, name both so future treatment for the leg stays covered. The mistake to avoid is listing only one body part, which can let the carrier deny later treatment for the parts you left off. Many filers think they can add body parts later without trouble, but leaving one off now invites a fight over whether that injury is even part of the claim.
City and County Where the Injury Occurred
This box asks for the location of your accident, and it controls where your hearing happens. Write the city and the county, because the Commission sets the hearing in that county by default. For example, Carlos writes Greensboro, Guilford County.
If you were injured while driving for work across county lines, use the county where the accident physically happened. The common mistake is naming the county where you live instead of where you were hurt, which can send your hearing to the wrong courthouse. Filers often assume the hearing happens near home, but venue follows the injury county unless the Commission approves a change.
Estimated Length of Hearing
This field asks how long you expect the hearing to take. Give an honest estimate in hours, since most contested hearings run a few hours, so 2 hours or Half day is common. For example, Carlos writes 2 hours.
If your case has many witnesses or complex medical issues, estimate higher, like Full day, so the Commission reserves enough time. The mistake to avoid is wildly underestimating, which can force a continuance when the docket runs out of time. Some filers think this number is binding, but it is only a planning estimate the Commission uses to schedule the calendar.
Request for a Different County and Reason
This optional block lets you ask for a hearing in a county other than where the injury occurred, and it requires a reason. Name the county you want and explain why, such as a move or a witness location. For example, Carlos writes Wake County — plaintiff and treating physician both relocated to Raleigh.
If you have no reason to change venue, leave this blank and the hearing stays in the injury county. The common mistake is requesting a new county with no stated reason, which the Commission will reject. Filers sometimes believe they can pick any convenient county, but the Commission must authorize the change and needs a real justification.
“I, ___, Plaintiff/Attorney or Defendant/Attorney” Line
This line asks who is making the request and on which side. Write your name in the blank, then check Plaintiff/Attorney if you are the worker or worker’s lawyer, or Defendant/Attorney if you are the employer, carrier, or their lawyer. For example, Carlos Rodriguez writes his name and checks Plaintiff/Attorney.
If you are a self-represented worker, you still check the Plaintiff side even though you are not an attorney. The mistake to avoid is checking the wrong side, which confuses the Commission about who is seeking the hearing. Many filers think only lawyers fit on this line, but the label covers both the party and the attorney, so a pro se worker belongs on the Plaintiff side.
“We have been unable to agree because” (State Reason with Specificity)
This is the most important field on the form, and it asks why you and the other side cannot agree. State the dispute with detail, and if you are appealing an Administrative Order, give the file date of the Order and the name of the hearing officer who issued it. For example, Carlos writes Carrier denied the claim on a Form 61 dated 04/20/2025, asserting the injury is not work-related; plaintiff disputes this and seeks medical and indemnity benefits.
If you are appealing a Form 24 decision that stopped your benefits, write something like Appealing the Administrative Order filed 05/02/2025 by Special Deputy Commissioner J. Hale terminating temporary total disability. The biggest mistake on the entire form is writing something vague like unfair or they denied me, which invites a motion to dismiss and a delay. Filers often think a one-word reason is enough, but specificity here frames the issues the judge will decide.
Benefit Checkboxes: Days Missed, Medical, PPD, PTD, Scars, Other
This section asks which benefits are in dispute, and you check every box that applies. Mark Payment of compensation for days missed and give dates, Payment of medical expenses/treatment, Payment for permanent partial disability, Payment for permanent and total disability, Payment for scars, or Other with an explanation. For example, Carlos checks days missed (03/05/2025 to present) and medical expenses/treatment.
If you are unsure whether a future benefit applies, check it now and refine later, because raising it here preserves the issue. The common mistake is checking only one box when several apply, which can waive the benefits you left unchecked at hearing. Many filers think medical and wage benefits come automatically once they win, but the judge decides only the issues you actually raise on this form.
Has Claimant Participated in Mediation? Yes / No
This box asks whether the case has already gone through mediation. Check Yes or No honestly, since most contested cases must attend a mediated settlement conference before hearing. For example, Carlos checks No because his claim was just denied and no mediation has happened.
If mediation happened but failed, check Yes and the case proceeds toward hearing. The mistake to avoid is checking Yes when no mediation occurred, which can get your case bounced back to mediation and delay everything. Filers sometimes confuse a phone call from the adjuster with formal mediation, but mediation is a structured conference with a certified mediator, not a settlement phone call.
Page 2: Witness and Doctor List (Name and Address)
This section asks for the names of every witness and the names and addresses of every doctor whose testimony you want. List each one clearly, because the Commission issues subpoenas from this list, and doctor addresses are required. For example, Carlos lists Dr. Anita Shah, Triad Orthopedics, 215 Wendover Ave, Greensboro, NC 27408 and a coworker witness.
If you do not yet know every witness, list those you have and supplement later, but include your treating doctor now. The common mistake is naming a doctor without an address, which means no subpoena gets issued and your medical testimony falls through. People often assume their lawyer or the Commission will track down doctor addresses, but the form puts that duty on the requesting party.
Certification and Signature of Party Requesting Hearing
This block is your sworn statement that the case is ready and your signature. Sign on the Signature of Party Requesting Hearing line, check whether you are Employee, Employer, or Attorney, print your name, and add your mailing address, telephone, date of notice, and email. For example, Carlos signs, checks Employee, prints Carlos Rodriguez, and dates it 05/15/2025.
If you are filing electronically through the portal, your typed or e-signature satisfies this line. The mistake to avoid is leaving the signature blank, which makes the form invalid and stops it from being docketed. Filers sometimes think printing their name is the same as signing, but the form needs both the signature and the printed name to be complete.
Certificate of Service
This final block certifies that you sent a copy of the Form 33 to every other party. Fill in the date you served it, name each party and address you served, and check how you served them, such as U.S. Mail, e-mail, fax, or hand delivery. For example, Carlos certifies he served Sentinel Casualty Insurance Co. by U.S. Mail on 05/15/2025, then signs and prints his name.
If multiple parties exist, list each one, attaching a separate sheet if the space runs out. The most damaging mistake is skipping the Certificate of Service, because filing the form without serving the other side can get your request dismissed. Many filers think mailing the form to the Commission alone is enough, but you must also serve the carrier and prove you did so right here.
Three Filled-Out Examples Using Real Scenarios
These three scenarios show how different filers complete the same form. Follow each named person from the top of the form to the Certificate of Service.
Scenario 1: Carlos, a pro se worker whose claim was denied. Carlos hurt his back lifting freight, and the carrier denied his claim outright. He files Form 33 himself to force a hearing.
| Form Section | What Carlos Enters |
|---|---|
| IC File # | 21-987654 (from his denial letter) |
| Employee’s Name | Rodriguez, Carlos |
| Date of Injury | 03/04/2025 |
| Part of Body | Lower back and right shoulder |
| City/County of Injury | Greensboro, Guilford County |
| Reason unable to agree | Carrier denied claim on Form 61 dated 04/20/2025; plaintiff disputes and seeks medical and indemnity benefits |
| Benefit boxes checked | Days missed (03/05/2025 to present); medical expenses/treatment |
| Mediation? | No |
| Witnesses/Doctors | Dr. Anita Shah, 215 Wendover Ave, Greensboro, NC 27408 |
| Signature block | Signs, checks Employee, dates 05/15/2025 |
Scenario 2: Janet, a represented worker appealing an Administrative Order. Janet’s benefits were stopped after a Form 24 decision, and her attorney files Form 33 to appeal. She had a 22-year career before her shoulder injury.
| Form Section | What Janet’s Attorney Enters |
|---|---|
| IC File # | 20-445566 |
| Employee’s Name | Coleman, Janet |
| Date of Injury | 08/12/2024 |
| Part of Body | Right shoulder and neck |
| Reason unable to agree | Appealing Administrative Order filed 05/02/2025 by Special Deputy Commissioner J. Hale terminating temporary total disability |
| Benefit boxes checked | Days missed; permanent partial disability |
| Mediation? | Yes (prior mediation failed) |
| Witnesses/Doctors | Dr. Lewis Tran, 900 Medical Park Dr, Charlotte, NC 28204 |
| Side checked | Plaintiff/Attorney |
| Filing channel | Electronic Document Filing Portal |
Scenario 3: Piedmont Logistics, an employer disputing ongoing disability. The employer believes Marcus can return to work and files Form 33 to end ongoing payments.
| Form Section | What the Employer Enters |
|---|---|
| IC File # | 22-112233 |
| Employee’s Name | Bell, Marcus |
| Date of Injury | 01/15/2025 |
| Part of Body | Left knee |
| Reason unable to agree | Employer contends plaintiff is capable of suitable work offered on 04/01/2025; seeks determination of ongoing disability |
| Benefit boxes checked | Other: ongoing temporary total disability and return-to-work capacity |
| Mediation? | No |
| Side checked | Defendant/Attorney |
| Witnesses/Doctors | Dr. Karen Ode, 12 Health Way, Raleigh, NC 27607 |
| Certificate of Service | Served plaintiff’s counsel by e-mail on 04/30/2025 |
How to File the Completed Form
You have four ways to file Form 33, and the right channel depends on whether you have a lawyer. Attorneys must file through the Electronic Document Filing Portal, while self-represented employees may use the portal, email, fax, or mail. There is no filing fee for Form 33, which removes a common worry for injured workers.
- Electronic Document Filing Portal: File online at the EDFP portal. This is required for attorneys and available to all filers, processing is fastest, and you should save the on-screen confirmation as proof of filing.
- Email: Self-represented employees may email the original to dockets@ic.nc.gov. Keep the sent email and any auto-reply as your proof.
- Fax: Employees may fax the form to (919) 715-0282. Keep the fax transmission confirmation page as proof.
- Mail: Send the original to NCIC-Docket Section, 1236 Mail Service Center, Raleigh, NC 27699-1236. Use certified mail with return receipt and keep the green card as proof.
No matter which channel you choose, you must also serve a copy on every opposing party, and the Certificate of Service is where you prove it. The Docket Section then assigns your case, and the other side has 45 days to file the Form 33R response. Keep copies of everything, because your proof of filing protects you if the carrier later claims it never received the request.
What Happens After You File
Once the Commission dockets your Form 33, the case shifts into the litigation track. The opposing party must file a Form 33R response within 45 days, laying out their defenses. The Commission then orders the parties to attend a mediated settlement conference before any hearing.
Mediation is a required step in most contested cases, and many disputes settle there without a judge. If mediation fails, the Commission places your case on a hearing calendar before a Deputy Commissioner in the injury county. You will receive a hearing notice by mail, which is why a correct address on the form matters so much.
At the hearing, the Deputy Commissioner takes evidence and testimony, then issues a written Opinion and Award. If either side disagrees, they can appeal to the Full Commission and later to the North Carolina Court of Appeals. The whole process from filing to decision often takes several months, so filing a clean, specific Form 33 early keeps your case from stalling at the starting line.
Mistakes to Avoid When Filling Out the Form
Small errors on Form 33 cause big delays, and many are avoidable. Watch for these.
- Writing a vague reason like unfair in the “unable to agree” box; this invites a motion to dismiss and delays your hearing.
- Checking only one benefit box when several apply; you can waive the benefits you left unchecked.
- Leaving the IC File # blank when you have one; this can create a duplicate file and confusion.
- Guessing a file number you do not have; this can attach your request to a stranger’s claim.
- Listing an old mailing address; you miss hearing notices and risk dismissal for failure to prosecute.
- Naming a doctor without an address on page 2; the Commission cannot issue a subpoena, and your medical testimony falls through.
- Forgetting the signature; an unsigned form is invalid and never gets docketed.
- Skipping the Certificate of Service; filing without serving the other side can get your request dismissed.
- Checking Yes on mediation when none occurred; the case gets bounced back and delayed.
- Naming the wrong county; your hearing gets set in the wrong courthouse.
- Using a trade name instead of the legal employer name; service goes to the wrong company.
- Entering a date of injury that conflicts with your Form 18; the carrier gains a timeliness defense.
Do’s and Don’ts
A few habits make your filing stronger and your case smoother.
Do:
- Do state your reason for the hearing with concrete facts and dates, because specificity frames the issues the judge decides.
- Do check every benefit box in dispute, since unchecked benefits may be waived.
- Do confirm the 04/2023 revision date on the form, so the Commission does not reject an old version.
- Do keep proof of filing and proof of service, because they protect you if a party claims it never received the form.
- Do list your treating doctor with a full address, so the Commission can issue the subpoena.
- Do double-check your mailing address, because every hearing notice goes there.
Don’t:
- Don’t write a one-word reason, because vague filings draw motions to dismiss.
- Don’t leave the signature line blank, since an unsigned form is invalid.
- Don’t skip the Certificate of Service, because unserved filings get dismissed.
- Don’t guess at your IC File Number, since a wrong number tangles your file.
- Don’t use a nickname in the name field, because it breaks the match to your claim.
- Don’t claim mediation happened when it did not, because the case gets sent back.
Pros and Cons of Filing on Your Own vs. With Help
Many injured workers wonder whether to file Form 33 alone or hire an attorney. Both paths are legitimate, and the right choice depends on how complex and contested your claim is.
Pros of filing pro se:
- You save attorney fees, which matters when money is tight after a lost paycheck.
- You keep full control over your own filing and timeline.
- Simple, clearly documented disputes can be straightforward to file yourself.
- Self-represented employees get extra filing channels like email and fax.
- You learn your own case deeply by handling it directly.
Cons of filing pro se:
- A vague “reason” statement can trigger a motion to dismiss you might not know how to fight.
- You may check the wrong benefit boxes and waive valuable benefits.
- You handle subpoenas, medical evidence, and deadlines without guidance.
- Carriers have experienced defense lawyers, which creates an uneven match.
- One missed step, like the Certificate of Service, can sink an otherwise strong claim.
Most workers’ compensation attorneys offer free consultations and work on a contingency fee set by statute, so getting advice before you file often costs nothing upfront. If your claim was outright denied or your benefits were terminated, the stakes usually justify at least a consultation, as firms like Martin & Jones explain for denied claims.
Form 33 vs. Form 33R: How They Differ
These two forms work as a pair, and confusing them causes filing errors. One starts the dispute, and the other answers it.
| Form 33 | Form 33R |
|---|---|
| Filed by the party requesting a hearing | Filed by the opposing party in response |
| Asks the Commission to assign the claim for hearing | States the responding party’s defenses and position |
| Triggers the 45-day response clock | Due within 45 days of receiving the Form 33 |
| Lists the filer’s witnesses and doctors | Lists the responding party’s witnesses and doctors |
| Can be filed by employee, employer, or attorney | Usually filed by the carrier or defense attorney |
Key Agencies and Related Forms
Form 33 sits inside a web of agencies and forms that shape your claim. Knowing each role helps you keep your case on track.
- North Carolina Industrial Commission: The state agency that receives Form 33 and decides workers’ compensation disputes, governed by N.C. Gen. Stat. § 97-83.
- Form 18: The injured worker’s notice of accident and claim, which starts the claim before any hearing request.
- Form 33R: The opposing party’s formal response to your Form 33.
- Form 24: The application a carrier files to stop benefits, and the decision you often appeal with Form 33.
- Form 36: Contains the subpoena service instructions referenced on page 2 of Form 33.
- Form 61: The carrier’s denial of a claim, which often becomes the reason you file Form 33.
A common misconception is that filing Form 33 starts your whole claim, but the claim usually begins with a Form 18, and Form 33 only moves an existing dispute to a hearing. Skipping the Form 18 step can leave you without a docketed claim to litigate.
FAQs
Do I have to pay a fee to file Form 33?
No. There is no filing fee for Form 33 with the North Carolina Industrial Commission, so cost should never stop you from requesting a hearing on a contested claim.
Can I file Form 33 myself without a lawyer?
Yes. Self-represented employees may file Form 33 by portal, email, fax, or mail, though complex or denied claims often benefit from at least a free attorney consultation first.
Do I write my reason for the hearing in detail or keep it short?
No. Keep it short and you risk a motion to dismiss; the “unable to agree” box must state your dispute with specific facts, dates, and benefits sought.
If I am appealing an Administrative Order, what goes in the reason box?
Yes. You must include the file date of the Order and the name of the hearing officer who issued it, then briefly state why you disagree with that decision.
Do I have to provide my Social Security number on Form 33?
No. Disclosure is voluntary under the form’s own statement, but providing it helps the Commission verify your employer and find insurance coverage faster.
Should I check the mediation box Yes if the adjuster called me about settling?
No. A settlement call is not mediation; check Yes only if you attended a formal mediated settlement conference with a certified mediator.
Do I list only my main injury in the Part of Body field?
No. List every injured body part, because leaving one off can let the carrier deny later treatment for the part you omitted.
Can the employer or insurance carrier file Form 33?
Yes. A defendant can file Form 33 to force a hearing, often over a worker’s return-to-work capacity or to end ongoing disability payments.
Do I have to serve the insurance carrier with a copy?
Yes. You must serve every opposing party and prove it in the Certificate of Service, or the Commission can dismiss your request.
Will my hearing be held near my home?
No. The hearing is set in the county where the injury occurred unless the Commission approves a different county for a stated reason.
Do I need a doctor’s address on the witness list?
Yes. Addresses are required for every doctor listed, because the Commission issues subpoenas from that list and cannot serve a doctor without one.
How long does the other side have to respond to my Form 33?
Yes. The opposing party must file a Form 33R within 45 days of receiving your Form 33, after which the case moves toward mediation and hearing.
Is there a deadline to file my workers’ compensation claim before I even reach Form 33?
Yes. Under N.C. Gen. Stat. § 97-24, you generally must file your claim within two years of the injury, or you can lose your right to benefits.
Can I add witnesses after I file Form 33?
Yes. You can supplement your witness list later, but list your treating doctor and known witnesses now so subpoenas can issue without delay.
Related reading
- How to Fill Out North Carolina Form AOC-CV-101 (w/Examples) + FAQs
- How to Fill Out North Carolina Form B-12 (w/Examples) + FAQs
- How to Fill Out North Carolina Industrial Commission Form 18 + FAQs
- How to Fill Out North Carolina Industrial Commission Form 21 + FAQs
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