1. Except as otherwise provided in this section, a treating physician or chiropractic physician shall, within 3 working days after first providing treatment to an employee who has incurred an occupational disease, complete and file a claim for compensation with the employer of the employee and the employers insurer. If the employer is a self-insured employer, the treating physician or chiropractic physician shall file the claim for compensation with the employers third-party administrator. If the physician or chiropractic physician files the claim for compensation by electronic transmission, the physician or chiropractic physician shall, upon request, mail to the insurer or third-party administrator the form that contains the original signatures of the employee and the physician or chiropractic physician. The form must be mailed within 7 days after receiving such a request. 2. A physician or chiropractic physician who has a duty to file a claim for compensation pursuant to subsection 1 may delegate the duty to a medical facility. If the physician or chiropractic physician delegates the duty to a medical facility: (a) The medical facility must comply with the filing requirements set forth in this section; and (b) The delegation must be in writing and signed by: (1) The physician or chiropractic physician; and (2) An authorized representative of the medical facility. 3. A claim for compensation required by subsection 1 must be filed on a form prescribed by the Administrator. 4. If a claim for compensation is accompanied by a certificate of disability, the certificate must include a description of any limitation or restrictions on the employees ability to work. 5. Each physician, chiropractic physician and medical facility that treats employees who have incurred occupational diseases, each insurer, third-party administrator and employer, and the Division shall maintain at their offices a sufficient supply of the forms prescribed by the Administrator for filing a claim for compensation. 6. The Administrator may impose an administrative fine of not more than $1,000 for each violation of subsection 1 on: (a) A physician or chiropractic physician; or (b) A medical facility if the duty to file the claim for compensation has been delegated to the medical facility pursuant to this section.
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