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Form WC76 Request for Appointment to the Division Independent Medical Examination Panel (Dime) - Colorado
What Is Form WC76?
This is a legal form that was released by the Colorado Department of Labor and Employment - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the WC76 form?
A: The WC76 form is the Request for Appointment to the Division Independent Medical Examination Panel (DIME) in Colorado.
Q: What is the Division Independent Medical Examination Panel (DIME)?
A: The DIME is a panel of medical professionals that evaluate workers' compensation cases in Colorado.
Q: What is the purpose of the WC76 form?
A: The WC76 form is used to request an appointment to the DIME panel for an independent medical examination in a workers' compensation case.
Q: Who needs to fill out the WC76 form?
A: The WC76 form is typically completed by injured workers or their legal representatives who are seeking an independent medical examination.
Q: How should the WC76 form be submitted?
A: The WC76 form should be submitted to the Division of Workers' Compensation by mail or in person at the appropriate office.
Form Details:
- Released on October 1, 2018;
- The latest edition provided by the Colorado Department of Labor and Employment;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form WC76 by clicking the link below or browse more documents and templates provided by the Colorado Department of Labor and Employment.
Download Form WC76 Request for Appointment to the Division Independent Medical Examination Panel (Dime) - Colorado
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