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Form — Hearing Report — No Second Injury Fund — 14-0047



Hearing Report for Cases in Which the Second Injury Fund of Iowa Is Not a Party




The parties to a case must jointly complete and eFile a hearing report in Microsoft Word format on WCES at least 14 days prior to hearing.

To download the version of the form in Word format for cases in which SIF is not a party, click on the link.


To type text into a blank on the form, click on the blank so that the field is highlighted and type.

To select whether an issue is "Stipulated" or "Disputed" and whether a defense is "Asserted" or "Waived":

  1.  Click on the blank so the field is highlighted.
  2. Click on the arrow to the right of the blank.
  3. Select from the drop-down.

To check a box, move your cursor arrow over the center of the box and left-click.

How to Save Form as PDF for eFiling

The Hearing Report form is in Microsoft Word format to allow counsel for the parties to more efficiently collaborate on its contents.

Effective March 15, 2023, agency rule 876 IAC 2.8 requires the proposed hearing report be filed in PDF format.

You may convert the completed hearing report form from Microsoft Word to PDF by:

  • Clicking "File" on the top bar of the Microsoft Word doc.
  • Clicking "Save As."
  • Changing the form name to one of your choosing (e.g., "Doe v. ABC, Inc. - Hearing Report").
  • Beneath the doc name, choosing PDF as the file type.
  • Clicking "Save."

Taking these steps will give you a PDF version of the proposed hearing report saved on your computer for filing in accordance with agency rules.

eFiling on WCES

The DWC requires electronic filing (eFiling) on the Workers' Compensation Electronic System (WCES).

The completed hearing report form must be eFiled on WCES.

For more information about eFiling on WCES, click here.