An interested party or authorized representative may file a Petition for Rearrangement or Readjustment of Compensation if a qualifying change in earning capacity or condition has occurred since the last loss of earning capacity determination was made. The burden of proof to establish the change rests with the filing party. This form may be used to file a Petition for Rearrangement or Readjustment of Compensation. It must be completed in its entirety. Failure to do so may cause a delay in processing.
