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Workers' Compensation Forms

This page contains helpful links to some of the forms needed to pursue a workers compensation claim in Colorado.

Basic Claims Process. This guide is published by the Colorado Division of Workers Compensation. It provides helpful information on how a claim goes forward.

Claim form. This form provides notice of the injury to the insurance company and the Division of Workers Compensation.

Application for Hearing. This is filed to request a hearing before the Office of Administrative Courts.

Request for Expedited Hearing. Under some circumstances, a hearing can be expedited. However, expedited hearings are often postponed which can delay a hearing beyond the date it would have occurred if you had gone through the normal hearing process.

Notice and Proposal to Select Independent Medical Examiner. This form is used by a party to initiate a request for a Division Independent Medical Exam (IME) and to propose the name of a physician to perform the exam.

Application for Division Independent Medical Examination. After filing a Notice and Proposal (Form WC146), this application is used by a claimant or insurer to request and Independent Medical Examination (IME) through the Division for a determination of Maximum Medical Improvement (MMI), permanent impairment, or both.

Application for Indigent Determination (IME). This application is used by claimants who can't afford to pay the fees for a Division IME.

Call the Eley Law Firm today at 866.458.6360 or 720.279.9172 for a free case evaluation from a workers compensation attorney. You may also Contact Us or fill out the form on the Contact Us page of this website, and a representative from the office will be in touch with you shortly. We look forward to hearing from you and helping with your workers comp case!

Eley Law Firm 1873 South Bellaire Street, Suite 1200 | Denver CO 80222 | Phone: 720.279.9172 or 866. 458.6360
Fax: 303.226.4774 | Denver Law Office

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