The Iowa Division of Workers' Compensation (DWC) requires the use of agency forms for certain filings.
This page contains links to help you find and use current DWC forms.
Index
To view forms under a category, click on the corresponding link below:
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To search all DWC forms and publications, click here.
Pleadings
Arbitration
Form 100 — Original Notice & Petition
Independent Medical Examination (IME)
Form 100A — Original Notice & Petition Concerning Application for IME (14-0007)
Form 100A — Answer to Petition Concerning Application for IME (14-0007A)
Vocational Rehabilitation Program Benefit Under Iowa Code Section 85.70(1)
Form 100B — Answer Concerning Vocational Rehabilitation Program Benefit (14-0009A)
Alternate Care
Form 100C — Original Notice & Petition Concerning Application for Alternate Care (14-0011)
Form 100C — Answer to Petition Concerning Application for Alternate Care (14-0011A)
Vocational Education & Training
Hearing
Hearing Report
Hearing Report — No Second Injury Fund (14-0047)
Hearing Report — Second Injury Fund (14-0047)
Shorthand Reporter Identification
Shorthand Reporter Identification (14-0178)
Settlement
Agreement for Settlement (14-0021)
Compromise Settlement (14-0025)
Combination Settlement (14-0159)
Contingent Settlement (14-0161)
Claimant's Statement (14-0163)
Commutation
Payment of Benefits
Payment Activity Report (PAR) (14-0147)
Application for Payment of Benefits (14-0037
Filing
Application to Defer Payment of Filing Fees & Financial Affidavit (14-0075)
Application for eFiling Exception (14-0176)
Records
Authorization to Release Information (14-0196)
Miscellaneous
Medical Report Transmittal Form (14-0141)