• Form 1043 Questions Answered

    The ability to electronically file a Form 1043 Agreement to Compensation for TTD has created a question as to whether it is necessary to prepare and provide a paper Form 1043 to the employee for signature and filing.  Despite the electronic filing of Form 1043, it is still required and important to have a signed and approved paper Form 1043 Agreement to Compensation for TTD.

    If the employee’s claim is being accepted, the TTD compensation should be timely paid and an unsigned Form 1043 timely filed electronically for compliance purposes.  But, a paper Form 1043 should also be prepared, signed by the employer/insurer/TPA and provided to the employee for review and signature with instructions that it be returned to the employer/insurer/TPA.  When returned, the paper Form 1043 should be sent to the Board with an extra copy and a prepaid envelope. The Board will review and approve the Form 1043 and send the copy back in the prepaid envelope.

    It is the signed and approved paper Form 1043 which constitutes an Award and establishes as fact the statements contained therein.  Indiana Code 22-3-3-7 (b) still requires a timely tender to the employee of the compensation due and “a properly prepared compensation agreement” when the employer has accepted a claim where TTD is due. If the employee fails to return the paper Form 1043, the electronically filed Form 1043 and the employer’s record of TTD compensation paid prove the employer’s compliance despite the employee’s failure.

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