Form — Shorthand Reporter Identification — 14-0178

File: 
PDF icon Shorthand Report Identification -- Form 14-0178 -- July 2019.pdf
Description: 

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Name

Shorthand Reporter Identification

Number

14-0178

Effective

July 22, 2019

Overview

This form is used by a party to a case before the Iowa Workers' Compensation Commissioner to identify the certified shorthand reporter appointed by the presiding officer at hearing.

Instructions

Click on the link above to open the form in PDF format. You may then type into the form to complete it and save the completed form.

To complete this form:

  1. On the left-hand side of the caption, provide the full name of the claimant, employer, and any insurance carrier.
  2. On the right-hand side of the caption, provide the file number(s) for the case.
  3. Under the "Hearing" header, identify the date on which the hearing was held and the type of hearing (e.g., arbitration).
  4. Under the "Shorthand Reporter" header, identify:
    • The name of the shorthand reporter.
    • The name of the firm (if any) for which the shorthand reporter works.
    • The email address of the shorthand reporter.
    • The phone number of the shorthand reporter.
    • The address of the shorthand reporter.
  5. If the party filing the form is represented by an attorney, the attorney should provide the requested information and sign the form. If the party is self-represented and does not have any attorney, the party should provide the requested information and sign the form. If you use an electronic signature under agency rules, lock or "flatten" the PDF document after completing the form fields to ensure the document can be viewed on all devices and to prevent other users from manipulating or editing the information.
  6. The person who serves the form should complete and sign the Certificate of Service.

eFiling on WCES

The Iowa Division of Workers' Compensation (DWC) requires parties and attorneys to electronically file (eFile) documents on the Workers' Compensation Electronic System (WCES) in contested case proceedings.

You must eFile on WCES documents, such as this completed form, unless the DWC has granted you an eFiling exception.

For more information about eFiling, click here.