Can the Board accept electronic signatures?

Yes in most cases where state law allows electronic signatures; ESIGN (15 U.S.C. ch. 96) and UETA (1999) generally make e-signatures legally equivalent to handwritten ones. Confirm Board rules and any consumer-disclosure or authentication requirements before e-submitting.

Are notaries required?

Notarization requirements vary by document and state; many routine claim forms do not need notarization, but settlement documents often require notarized signatures. For remote notarization (RON), verify state notary rules and retention of audio-video records before using RON.

What happens if information is incorrect?

Incorrect or inconsistent information can delay processing, prompt requests for corrected forms, and risk denial of benefits. Timely corrections, authenticated affidavits, or supplemental records can mitigate harm, but significant errors may require rehearing or legal counsel involvement.

How long must records be retained?

Retention periods depend on record type: keep payroll and financial records at least three years per IRS guidance (IRC §6501(a)), retain HIPAA-related medical records six years (45 CFR §164.530(j)), and preserve I-9s per 8 CFR §274a.2.

Can I e-file evidence?

Many Boards accept electronic exhibits, but file-format, size limits, and submission method vary. Submit PDFs for documents, label exhibits clearly, and confirm the Board's process for large files or multimedia evidence to avoid technical rejection.

Where to get Board forms?

Obtain official forms and filing instructions from the Alaska Workers' Compensation Board or Department of Labor office or website. Use the most current Board form versions, and check procedural rules for filing, service, and hearing requirements.

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Alaska Workers' Compensation Board

Alaska Workers' Compensation Board

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DEATH BENEFITS REPORT

ALASKA DEPARTMENT OF LABOR & WORKFORCE DEVELOPMENT

P.O. Box 115512, Juneau AK 99811-5512

AWCB Case Number:

Complete this form and attach to Compensation Report (Form 07-6104) when you begin, change, suspend or terminate death benefits payments.

1. Deceased Employee's Name (Last, First, Middle Initial)

2. Insurer Claim Number

3. Date of Injury

4. Date of Death

5. Social Security Number

6. Place of Death

7. Date of Birth

8. Employer

9. Insurer

10. Address

11. Address

12. WIDOW(ER) AND/OR CHILDREN:

13. DEPENDENT PARENTS, GRANDCHILDREN, BROTHER(S) AND/OR SISTER(S):

This is to certify that the original Death Benefits Report and the Compensation Report (Form 07-6104) have been mailed to all dependents at the above address(es), and copies have been mailed to the Alaska Workers' Compensation Board.

14. Name and Title of Person Submitting Report (Print or Type)

15. Signature

16. Report Date

17. Address

City

State

Zip Code

Telephone

What the Alaska Workers' Compensation Board Covers

The Alaska Workers' Compensation Board is the administrative body that adjudicates workplace injury claims, reviews benefit determinations, and enforces Alaska's workers' compensation laws. Employers, employees, insurers, and medical providers interact with the Board through claims filings, hearings, settlement approvals, and appeals. Documents submitted to the Board include claim forms, medical reports, employer notices, settlement agreements, and hearing exhibits. Procedures combine statutory deadlines, evidentiary rules, and administrative orders. This guide explains what the Board handles, the usual form fields you must complete, how filings differ from other states, and options for electronic submission and signature where permitted.

Why Accurate Board Filings Matter

Using correctly completed Board forms helps preserve benefit rights, avoid processing delays, and create an official record for hearings or appeals. Accurate, timely filings reduce the risk of denied claims and administrative penalties while supporting clearer communication among employers, medical providers, and insurers.

Who Interacts with the Board and Why

Employers, injured workers, insurers, medical providers, and attorneys regularly interact with the Alaska Workers' Compensation Board.

Employers and HR representatives — file employer notices, respond to claims, and provide wage and employment records.
Injured workers and claimants — submit initial claim forms, medical authorizations, and notice of hearing preferences.
Insurers, third-party administrators, and attorneys — manage claim investigations, settlements, and appear at hearings.

Essential Elements of a Complete Submission

Core components of a professional submission ensure clarity, admissible evidence, and procedural compliance for Alaska Workers' Compensation Board matters and properly articulated relief requests.

Claim Header

Include claimant and employer legal names, claim number, date of injury, employer contact details, and the case manager or insurer reference so the Board can identify the matter and link supporting records efficiently.

Injury Details

Describe injury mechanism, body part affected, witness names, first treatment dates, and work status information to support causation and appropriate benefit calculations during evaluation and diagnoses.

Medical Records

Attach or reference medical reports, diagnostic tests, provider notes, treatment plans, and billing codes; accurate medical documentation is essential for benefit authorization and dispute resolution.

Employer Info

Provide employer's legal name, FEIN if available, payroll records for wage-loss calculations, and contact for claims administration to allow timely employer response and benefit determinations.

Relief Requested

State specific remedies sought such as medical treatment authorization, temporary total disability, vocational rehabilitation, or lump-sum settlement with precise dates and amounts where applicable, and legal basis.

Exhibits & Proof

Number exhibits, include hearing summaries, chronologies, witness statements, and any prior Board orders or settlement agreements to make records accessible for adjudicators and include an exhibit index.

Step-by-Step: Preparing and Submitting a Claim

Follow this step-by-step sequence to prepare and submit a claim to the Alaska Workers' Compensation Board.

01

Gather Records: Collect medical, employer, and witness documentation.
02

Complete Form: Enter required fields and attach exhibits.
03

Authenticate Signatures: Obtain required signatures or e-signature consent.
04

Submit & Track: Send filing to the Board and save confirmation.

Configuring an Online Submission Workflow

Configure online submission workflows to ensure required fields, signer authentication, and record retention meet Alaska Board expectations.

Field name and configuration options	How to set this field for Board submission
Signer authentication method and strength	Email link, SMS code, or stronger KBA.
Required Fields & Validation Rules	Enforce mandatory claim fields and date format.
File Attachments & Size Limits	Allow PDFs, limit each file to 10 MB.
Retention and Audit Trail Settings	Preserve submission metadata, timestamps, and exportable audit logs.

Where to Send Board Filings and Evidence

This sequence describes typical destinations and routing options for filing a claim or submitting evidence to the Alaska Workers' Compensation Board.

Online Portal: Use Board's electronic submission portal if available.
Mail: Send hard copies by certified mail with return receipt.
Email: Submit supporting documents to designated Board email address.
Hearing Packet: Deliver bound exhibits to the hearing clerk before the scheduled date.

Digital Filing: Platform Capabilities to Check

For digital filing and eSubmission, ensure your platform supports required authentication, accepted document formats, and integrations with case management or cloud storage providers.

Accepted Formats: PDF, DOCX, and Excel supported.
Integrations: Salesforce, NetSuite, Microsoft 365, Google Workspace.
Authentication: Email, SMS, SSO, or stronger MFA options.

Timing and Submission Expectations

Timing varies by claim type and procedural posture; meet statutory notice and filing deadlines to preserve benefits and appeal rights.

Notice of Injury:

Provide employer notice as soon as practicable; state deadlines vary.

Claim Filing:

File initial claim or form per Board procedures; timeliness affects benefits.

Medical Records Submission:

Submit records promptly to support medical necessity decisions.

Settlement Review Period:

Allow time for Board review and approval before finalizing settlements.

Appeals and Hearings:

Deadlines for appeals are procedural and vary; request hearing dates early.

Common Mistakes to Avoid

Incomplete or missing medical documentation delays adjudication, often prompting continuances, requests for supplemental records, and potential denial of treatment or indemnity benefits.
Using inconsistent names or dates across employer reports, medical records, and signature blocks creates identity verification issues and may require notarized proof or corrected filings.
Relying on handwritten, illegible entries for key fields increases data-entry errors and may lead the Board to request rewritten, typed, or certified copies.
Failing to follow the Board's exhibit numbering and submission format can cause misplaced evidence or exclusion at hearing; adhere to formatting instructions carefully.

Consequences of Incorrect or Late Filings

Benefit Delay: Payments postponed pending clarification

Claim Denial: Failure to timely file may forfeit rights

Administrative Fines: Possible monetary penalties for noncompliance

Evidence Exclusion: Untimely exhibits may be excluded

Appeal Limitations: Missed deadlines restrict appeal options

Employer Penalties: Penalties for failing to report claims

Practical Filing Examples

Realistic examples illustrate common filing patterns and submission outcomes for Alaska Workers' Compensation Board matters.

Employer Submission

An employer submits a response including payroll records, an incident narrative, witness names, and any safety reports to contest or clarify claimed facts.

Employer disputes cause and lists corrective actions.
The Board evaluates employer documentation alongside medical evidence; clear supporting exhibits and timely responses can narrow issues at hearing, reduce contested issues, and often speed resolution through settlement or targeted adjudication.

Claimant Medical Evidence

A claimant files detailed medical reports, provider statements, and a timeline of symptoms, documenting initial treatment dates and work restrictions to support disability claims.

Medical causation is thoroughly documented.
A well-organized medical exhibit packet with signed releases expedites record review; absence of complete imaging or provider notes often prompts continuance or requests for supplemental evidence and may delay benefit determinations.

Representative eSignature Pricing and Feature Comparison

Compare baseline e-signature pricing and core features relevant to filing and e-submission for administrative claims.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	Varies by plan
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions about Board Filings

Answers to common questions about completing, signing, and submitting documents to the Alaska Workers' Compensation Board, including electronic signature and retention concerns.

Need help? Contact support

Can the Board accept electronic signatures?
Yes in most cases where state law allows electronic signatures; ESIGN (15 U.S.C. ch. 96) and UETA (1999) generally make e-signatures legally equivalent to handwritten ones. Confirm Board rules and any consumer-disclosure or authentication requirements before e-submitting.
Are notaries required?
Notarization requirements vary by document and state; many routine claim forms do not need notarization, but settlement documents often require notarized signatures. For remote notarization (RON), verify state notary rules and retention of audio-video records before using RON.
What happens if information is incorrect?
Incorrect or inconsistent information can delay processing, prompt requests for corrected forms, and risk denial of benefits. Timely corrections, authenticated affidavits, or supplemental records can mitigate harm, but significant errors may require rehearing or legal counsel involvement.
How long must records be retained?
Retention periods depend on record type: keep payroll and financial records at least three years per IRS guidance (IRC §6501(a)), retain HIPAA-related medical records six years (45 CFR §164.530(j)), and preserve I-9s per 8 CFR §274a.2.
Can I e-file evidence?
Many Boards accept electronic exhibits, but file-format, size limits, and submission method vary. Submit PDFs for documents, label exhibits clearly, and confirm the Board's process for large files or multimedia evidence to avoid technical rejection.
Where to get Board forms?
Obtain official forms and filing instructions from the Alaska Workers' Compensation Board or Department of Labor office or website. Use the most current Board form versions, and check procedural rules for filing, service, and hearing requirements.

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