law: The Employee's Compensation Act, 1923
  22. Form of application.-
  4[(1) Where an accident occurs in respect of which liability to pay compensation under this Act arises, a claim for such compensation may, subject to the provisions of this Act, be made before the Commissioner.
  (1A) Subject to the provisions of sub-section (1), no application for the settlement] of any matter by a Commissioner, 5[other than an application by a dependant or dependants for compensation] shall be made unless and until some question has arisen between the parties in connection therewith which they have been unable to settle by agreement.
  (2) 6[An application to a Commissioner] may be made in such form and shall be accompanied by such fee, if any, as may be prescribed, and shall contain, in addition to any particulars which may be prescribed, the following particulars, namely:-
  (a) a concise statement of the circumstances in which the application is made and the relief or order which the applicant claims;
  (b) in the case of a claim for compensation against an employer, the date of service of notice of the accident on the employer and, if such notice has not been served or has not been served in due time, the reason for such omission;
  (c) the names and addresses of the parties; and
  (d) 5[except in the case of an application by dependants for compensation] a concise statement of the matters on which agreement has and 7[of] those on which agreement has not been come to.
  (3) If the applicant is illiterate or for any other reason is unable to furnish the required information in writing, the application shall, if the applicant so desires, be prepared under the direction of the Commissioner.
  4. Subs. by Act 30 of 1995, s. 11, for certain words (w.e.f.15-9-1995).
  5. Ins. by Act 15 of 1933, s. 15.
  6. Subs. by s. 15, ibid., for "where any such question has arisen, the application".
  7. Subs. by Act 37 of 1925, s. 2 and the First Schedule, for "on".
  State Amendment
  Uttar Pradesh
  Amendment of section 22 of Act No. 8 of 1923.-
  In section 22 of the Employees' Compensation Act, 1923, in sub-section (1-A) the following proviso shall be inserted at the end, namely:-
  "Provided that if an application is not made before the Commissioner by an employee or by dependent or dependents thereof within a period of ninty days from the date of the occurrence of the accident, then without prejudice to the right conferred to an employee or dependent or dependents thereof under this act or the rules made thereunder, such application may be filed by an officer authorized by the State Government in this behalf for the purpose of compensation to be paid to such employee or dependent or dependents thereof;
  Provided further that where it comes to the notice of the Commissioner that applicant for compensation arising out of same accident has been filed by both the employee or dependent or dependents thereof and by the officer referred to in the first proviso, the Commissioner shall club both the applications and decide the same by single order without prejudice to the right of such employee or dependents thereof."
  [Vide Uttar Pradesh Act 27 of 2018, s. 2]