A new form, WC-40 Request for Compliance Hearing, has been created to facilitate requests for hearings before the agency director. The form can be used by any party to request various types of hearings such as Rule 5, Rule 4(2), compliance issues, etc. The form is available as a fill-in form on our website and can be found in the litigation section under the Forms tab. It should be printed and submitted on white paper.
At this time, the WC-104A Application for Mediation or Hearing is not available online. The form is being revised and the new version will then be available as a savable fill-in form.
The form WC-104B Application for Mediation or Hearing for health care is available online as a fill-in form. Please note that this form must be printed on orange paper. Improperly submitted forms will be returned.
The form WC-104C Application for Mediation or Hearing is now also available online as a fill-in form. Please note that this form must be printed on blue paper. Improperly submitted forms will be returned.
Also, most all of the agency's other online fill-in forms have been updated to allow the user to save the completed forms to their local computer hard drives. To take advantage of this feature, users must be using Adobe Reader version 8 or higher. A free download of the latest Adobe Reader software may be obtained from Adobe's website.
Please note that the agency is not accepting electronic filings at this time. All forms still need to be printed on paper and mailed to the agency.
Any questions concerning the agency's online forms may be directed to Sue Bickel at 517-322-1106.
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