Form: Request for Waiver of Mandatory eFiling on WCES (Last Updated March 2023)

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Title

Request for Waiver  of the Mandatory Use of WCES

Overview

The Iowa Division of Workers' Compensation (DWC) mandates that parties electronically file (eFile) documents in cases before the agency on the Workers' Compensation Electronic System (WCES). For more information about eFiling on WCES, click here.

This form allows a party to request the agency to grant a waiver of the mandatory use of WCES to eFile documents with the agency in a specific case.

Last Updated

March 2023

Form Number

14-00176

Instructions

1. Download the form by clicking on the link above.
2. Complete the form by typing the information into the fill-able fields on the PDF or by printing the form and handwriting in print the information on the printed form.
3. Complete the caption on the top part of the form by providing in the corresponding blank the:
   • Name of the claimant
   • Name of the employer
   • Name of any insurance carrier
   • Name(s) of any other defendant(s)
   • Any agency file number(s), if you know the number(s).

NOTE:  In some cases, there is not an insurance carrier (e.g., when the employer is self-insured) or any other defendant(s).

3. Complete the form by filling out paragraphs 1 through 4.
4. Provide applicant information underneath the signature line.
5. Sign the form on the Signature line.
6. File the completed form with the DWC.