All Iowa Workers Compensation forms

Workers Compensation - Applications

• Application to Defer Payment of Filing Fees, Financial Affidavit and Order IA-14-0075-WC

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Discovery

• Requests for Production of Documents to Carrier US-01367
• Claimant's First Set of Requests for Production US-01366
• Claimant's First Set of Interrogatories to Employer and Carrier US-01365

Workers Compensation - Dispute Resolution

• Dispute Resolution Conference Report IA-14-0041-WC

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Notices

• Original Notice and Petition and for Commutation of all Remaining Benefits IA-14-0013-WC

Workers Compensation - Official - Agreements

• Agreement For Settlement IA-14-0021-WC

Workers Compensation - Official - Authorizations

• Authorization to Release Information Regarding Claimants Seeking Workers Compensation Benefits IA-14-0043-WC

Workers Compensation - Official - Compromises

• Compromise Settlement IA-14-0025-WC

Workers Compensation - Official - Injury

• First Report of Injury Or Illness IA-14-0001-WC

Workers Compensation - Official - Notices

• Original Notice And Petition IA-14-0005-WC
• Original Notice And Petition And Order For Partial Commutation IA-14-0017-WC
• Original Notice, Petition, and Answer Concerning Application for Alternate Medical Care IA-14-0011-WC
• Original Notice, Petition, Answer and Order Concerning Vocational Rehabilitation Program Benefit IA-14-0009-WC
• Original Notice, Petition, Answer and Order Concerning Independent Medical Examination IA-14-0007-WC

Workers Compensation - Official - Payments

• Payment Activity Report IA-14-0147-WC

Workers Compensation - Official - Requests

• Copy / Information Request IA-14-0083-WC

Workers Compensation - Official - Settlements

• Combination Settlement IA-14-0159-WC
• Contingent Settlement IA-14-0161-WC

Workers Compensation - Official - Waivers

• Waiver For Release of Records IA-14-0169-WC

Workers Compensation - Orders

• Application and Consent Order for Payment of Benefits IA-14-0037-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Reports

• Hearing Report and Order Approving Same IA-14-0047-WC