099.00.97 Ark. Code R. 006
BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION.
CLAIM NO.________________
_________________________________, EMPLOYEE CLAIMANT
_________________________________, EMPLOYER RESPONDENT
_________________________________, CARRIER RESPONDENT
REPORT OF MEDIATION CONFERENCE
At the ([]telephone [] in person) conference on ____________________ (date)
authorized representatives of the Claimant ( [] Yes [] No) and the Respondent ( [] Yes [] No) attended, and the following issues were fully resolved by the parties in the presence of the undersigned mediator: [] None, or
A copy of this Report is filed in the case file and mailed to each party, who is to make any written objection as to its accuracy within ten (10) days to the Clerk of the Commission.
_________________________________
Mediator
099.00.97 Ark. Code R. 006