- The name of the employer;
- The name of the workers' compensation insurance carrier, if known;
- The name of the employee receiving the services;
- The general nature of the injury; and
- Where a claim has been filed, the claim number, if known.
If the employer or the workers' compensation insurance company refuses to pay bills for authorized medical treatment, when your case goes before the administrative law judge for an evidentiary hearing (trial), you can ask the judge to order the employer/insurer to pay the medical bills. If the judge believes that the employer/insurer refused to pay the medical bills without reasonable grounds, the judge may order the employer/insurer to pay additional amounts for your lawyer's fees and costs. For more information about these types of evidentiary hearings, read What to Expect If Your Case Goes to Trial.