Form Dws-Ark-237 - Notice To Employer And Employee Page 4
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4AWCC Form P
(Posting Notice)
A posting notice is mentioned in Ark. Code Ann. §11-9-403, Ark. Code Ann. §11-9-407 and
AW CC R ule 7. AWCC Form P satisfies all requirements.
Form P:
1. Is to be on display in a conspicuous place;
2. Tells employers what to do when an employee is injured;
3. Instructs employees to notify the employer immediately (or no later than the close of the next
business day) when injured;
4. Lists the claims office that will be handling the insurance aspects of the case;
5. Gives the claims office telephone number;
6. Announces the expiration date of the insurance policy; and
7. Provides telephone numbers for Arkansas W orkers' Co mpensation Com mission legal advisors if
either party needs assistance.
Employers without Form P may lose the use of Form N as a defense in litigation. Employees
disobeying instructions on Form P may delay their benefits or jeopardize the awarding of any benefits in a
contested case.
The AW CC furnishes samples, not supplies, of Form P. Carriers are to send their insureds an adeq uate
num ber, and self-insureds must arrange with a printer for the supply they need. Carriers and employers may
enlarge Form P for posting purposes.
Information about Form P is available from the Support Services Division (1-800-622-4472 or 501-682-
3930).
Ark. Code A nn.
§11-9-106(a): “Any person o r entity who w illfully and knowingly makes any material
false statement or representation, who willfully and knowingly omits or conceals any material information,
or who w illfully and knowingly employs any device, scheme, or artifice for the purpose of: obtaining any
benefit or payment; defeating or wrongfully increasing or wrongfully decreasing any claim for benefit or
payment; or obtaining or avoiding workers’ compensation coverage or avoiding payment of the proper
insurance prem ium, or who aids and abets for any of said pu rposes, under this chapter shall be guilty of a
Class D felony. Fifty percent (50%) of any criminal fine imposed and collected under .... this section shall
be paid and allocated in accordance with applicable law to the D eath and Perm anent Total Disability Trust
Fund administered by the Workers’ Compensation Commission.”
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