Can the manual be signed electronically?

Yes. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention criteria are met.

What makes an e-signature legally binding?

A valid e-signature requires evidence of signer intent, consent to transact electronically, reliable attribution of the act to the signer, and the ability to retain and reproduce the signed record.

Are HIPAA protections required for medical attachments?

Yes. When medical records attach to claims, apply HIPAA safeguards and a Business Associate Agreement if a third-party eSignature or storage vendor will handle protected health information.

How long must claim records be retained?

Follow applicable federal standards such as IRS minimums (IRC §6501(a)) and HIPAA retention (45 CFR §164.530(j)); retain claim files longer when litigation is possible.

Who may sign for an employer?

Only authorized signatories with documented delegation should sign. Maintain a current signatory list and require role and title on the signature block.

What if state execution rules differ?

Adjust the manual per state-specific notarization or witness requirements. When in doubt, require a notarized signature or follow local counsel guidance to avoid invalidation.

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LHWCA Procedure Manual

LHWCA Procedure Manual

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WORKERS' COMPENSATION MEDICAL SUMMARY

This form must accompany Workers' Compensation Claims and Petitions (See 8AAC 45.052).

1. A copy of the Summary (and any attachments) MUST be served on the adjuster or attorney of record.

2. Send the original of the Summary and copies of the attachments to the Alaska Workers' Compensation Board (addresses listed below).

Employee's Name (Last, First, Middle Initial)

AWCB Case Number

Date of Injury

Employer

Employee's Social Security Number

TO: (List all persons to whom you are mailing this summary. Include addresses.)

Please mark an "X" here if you have no medical records in your possession of this date.

List Medical Records in Chronological Order

Brief Description of Medical Record (option but please identify most important records)

Report Date

Doctor/Provider

Report Type

Proof of Service: I certify that I mailed a copy of this summary to the persons and addresses listed above:

Name of Person Certifying Service (Print or Type) Signature Date Mailed

Name of Person Who Prepared This Summary (Print or Type)

REPORT TYPE CODE: Chart Notes =C, Discharge Summary = D, Hospital Records =H,
Initial Report = I, Narrative Report =N, Operative Report = O, Physical Examination & History
= E, Progress Report = P, X-Ray Report = X, Miscellaneous = M, Second Independent
Medical Evaluation = SIME, Employer Independent Medical Evaluation = EIME

Alaska Department of Labor & Workforce Development

Alaska Workers' Compensation Board

P.O. Box 115512

Juneau, AK 99811-5512

(907) 465-2790

Alaska Department of Labor & Workforce Development

Alaska Workers' Compensation Board

3301 Eagle Street, Suite 304

Anchorage, AK 99503

(907) 269-4980

Alaska Department of Labor & Workforce Development

Alaska Workers' Compensation Board

675 Seventh Avenue, Station K

Fairbanks, AK 99701-4531

(907) 451-2889

Form 07-6103 (Rev 05/2012)

What the LHWCA Procedure Manual Covers

The LHWCA Procedure Manual documents standardized steps for handling Longshore and Harbor Workers’ Compensation Act claims, including intake, medical referrals, benefit calculations, claim adjudication, appeals, and employer/insurer responsibilities. It describes required records, confidentiality safeguards for health information, timelines for internal processing, and the interplay with e-signature acceptance under ESIGN and applicable state electronic transaction laws.

Why a Procedure Manual Matters for LHWCA Claims

A formal manual reduces processing errors, supports regulatory compliance, clarifies roles, and creates an audit-ready record for claims handling while helping ensure consistent claimant treatment across cases.

Primary users of a procedure manual

The manual is designed for teams who manage or review LHWCA claims and for those who need a repeatable, compliant process.

Employers and HR teams responsible for reporting workplace injuries and coordinating initial medical care.
Claims administrators and insurance adjusters who evaluate compensability, calculate benefits, and manage payments.
Attorneys, compliance officers, and case managers preparing appeals, hearings, or regulatory submissions.

Use the manual as a shared reference to reduce disputes, speed resolutions, and preserve required documentation.

Core sections to include in a professional manual

A complete manual groups content into discrete sections so users can quickly follow intake, adjudication, documentation, and appeals workflows.

Intake

Clear intake checklist and template forms for incident reports, claimant contact details, and immediate employer notifications to preserve evidence and establish timelines.

Medical Management

Guidance for medical referrals, independent medical exams, form completion, and handling protected health information consistent with HIPAA rules and business associate agreements.

Benefits Calculation

Step-by-step rules for computing temporary and permanent disability benefits, offsets, and wage-loss determinations with examples and calculation worksheets.

Claims Adjudication

Procedures for determining compensability, documenting findings, issuing determinations, and tracking appeal windows and evidence collection.

Appeals & Hearings

Instructions for preparing case files for hearings, assembling exhibits, witness statements, and meeting submission deadlines for administrative tribunals.

Recordkeeping

Retention and security practices, including secure storage, access controls, and audit trails to support audits and potential litigation.

Step-by-step: completing a standard LHWCA claim record

Follow this sequence to move a claim from report to resolution while maintaining a clear audit trail.

01

Report Receipt: Record date and reporter details immediately.
02

Initial Triage: Assess urgency and arrange medical care.
03

Documentation: Attach incident report, witness statements, and medical records.
04

Adjudication: Apply benefit rules and issue determination with rationale.

Overview: digital workflow for the manual

A digital workflow reduces delays by standardizing field placement, signer order, and evidence attachments for each claim.

Upload Templates: Store standardized intake and release templates.
Place Fields: Add name, date, and signature fields consistently.
Assign Signers: Define signer roles and order for approvals.
Capture Audit: Preserve timestamps, IP, and authentication logs.

Typical online customization settings for claim forms

Configure each setting before issuing forms to ensure consistent capture of required information and evidence.

Field	Configuration
Name Field	Mandatory; auto-validate alphabetic characters
Date Fields	MM/DD/YYYY; calendar picker enabled
Signature Field	Allow typed, drawn, or e-sign with audit trail
Attachment Field	Accept PDF, JPG, DOCX up to company size limit

Technical and compliance requirements for e-submission

Confirm your platform supports required formats, secure transmission, and authentication before moving to electronic workflows.

Document Formats: PDF, DOCX
Authentication: Email or SMS codes
Integrations: HR and claims systems

Ensure the chosen provider can produce exportable signed PDFs, maintain audit trails, and meet applicable compliance standards such as ESIGN and HIPAA where required.

Consequences of incomplete or incorrect manuals

Denied Benefits: Incomplete evidence may lead to claim denial or delay.

Regulatory Fines: Late filings or report failures can trigger penalties.

HIPAA Violations: Improper PHI handling risks civil penalties and breach reporting.

Legal Exposure: Errors can increase litigation and defense costs.

Reputation Harm: Frequent mistakes damage employer trust and retention.

Data Loss: Poor retention practices risk evidence unavailability.

Practical tips for accurate, efficient completion

Adopt standardized forms, version controls, and documented signatory authority to reduce friction and legal risk.

Use standardized templates

Maintain a single template library with versioning and change logs so everyone uses the current procedure, reducing discrepancies and processing time.

Validate critical fields

Require auto-validation for dates, names, and provider NPIs to prevent common data-entry mistakes that delay benefit payments.

Record authentication

Capture signer authentication evidence and an audit trail for every electronic signature to support admissibility and non-repudiation.

Train staff regularly

Provide recurring training and quick-reference guides so new and existing users apply procedures consistently across claims.

Process time expectations and internal deadlines

Define internal SLAs for each workflow step to ensure consistent handling and to meet external deadlines that may arise in claims or appeals.

Initial Acknowledgment:

Acknowledge receipt to claimant within 2–3 business days of report.

Medical Referral:

Arrange or confirm initial medical evaluation within 48–72 hours for urgent injuries.

Documentation Upload:

Upload incident and medical records to the claim file within 5 business days.

Benefit Determination:

Complete preliminary compensability decision within 10–15 business days where evidence allows.

Appeal Preparation:

Assemble hearing exhibits at least 21 days before scheduled administrative hearing.

eSignature vendor pricing and capability snapshot

Compare starting price, trial availability, bulk send, audit trail, HIPAA compliance, and envelope caps across common eSignature vendors; signNow is listed first per guidance.

	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	Yes, 7-day trial	Yes	Yes	Yes	Yes
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

FAQs and common execution issues

Answers to frequent questions about e-signing, legal validity, retention, and cross-jurisdiction variations when using a Procedure Manual.

Need help? Contact support

Can the manual be signed electronically?
Yes. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention criteria are met.
What makes an e-signature legally binding?
A valid e-signature requires evidence of signer intent, consent to transact electronically, reliable attribution of the act to the signer, and the ability to retain and reproduce the signed record.
Are HIPAA protections required for medical attachments?
Yes. When medical records attach to claims, apply HIPAA safeguards and a Business Associate Agreement if a third-party eSignature or storage vendor will handle protected health information.
How long must claim records be retained?
Follow applicable federal standards such as IRS minimums (IRC §6501(a)) and HIPAA retention (45 CFR §164.530(j)); retain claim files longer when litigation is possible.
Who may sign for an employer?
Only authorized signatories with documented delegation should sign. Maintain a current signatory list and require role and title on the signature block.
What if state execution rules differ?
Adjust the manual per state-specific notarization or witness requirements. When in doubt, require a notarized signature or follow local counsel guidance to avoid invalidation.

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