Forms and Publications
Publications
Order Form For Books
(PDF 21.94 KB)
Iowa Workers’ Compensation Manual (Rate Book)
Iowa Workers’ Compensation Laws
2007 Question and Answer Brochure
(97 KB)
2007 Iowa Workers' Compensation Manual
Excel (1569 KB)
PDF (3.11 MB)
(PDF Interest Table - 40 KB)
2006 Iowa Workers' Compensation Manual
(PDF 4.6 MB)
(Excel 673KB)
(PDF Interest Table - 40 KB)
2006 Question and Answer Brochure
(PDF 99 KB)
2005 Iowa Workers' Compensation Manual
(PDF 4.58 MB)
(Excel 713 KB)
(PDF Interest Table - 40 KB)
2004 Iowa Workers' Compensation Manual
(PDF 397 KB) (Excel
659 KB)
2003 Iowa Workers' Compensation Manual
(PDF 549 KB), (Excel
683.5 KB)
2002 Iowa Workers' Compensation Manual
(PDF 267 KB), (Excel
596 KB)
2001 Iowa Workers' Compensation Manual
(PDF 280 KB), (Excel
650 KB), (Word 857 KB)
2000 Iowa Workers' Compensation Manual
(PDF 343 KB)
1999 Iowa Workers' Compensation Manual
(PDF 300 KB)
Workers' Compensation Guide, Sixth Edition
(PDF 465 KB)
Forms
Employers First Report of Injury
(FROI) (rev'd 12-98)
(PDF 169 KB) (IAIABC form 1.2)
Iowa FROI Instructions
(rev'd 7-98)
Medical Transmittal Form
(rev'd 3-00)
(PDF 35 KB)
Corporate Officer Exclusion
(rev'd 6-03)
(PDF 63 KB)
Dispute Resolution Conference
Worksheet (rev'd 08/02)
(PDF 6.4 KB)
Claimant's Confidential
Information Form (rev'd 11-06)
(PDF 47 KB) must be filed with every original notice and petition.
Form 100 - Original Notice
and Petition (rev'd 11-06)
(PDF 28 KB)
Form 100A - 85.39 Petition
(rev'd 11-06)
(PDF 45 KB)
Form 100B - 85.70 Petition
(rev'd 11-06)
(PDF 44 KB)
Form 100C - 85.27 Petition
(rev'd 11-06)
(PDF 40 KB)
Application for Deferral of Filing Fee
(rev'd 7-99)
(PDF 46 KB)
Form 9 - Full Commutation
(rev'd 11-06)
(PDF 42 KB)
Form 9A - Partial Commutation
(rev'd 11-06)
(PDF 37 KB)
Hearing Report and Order
Approving Same (rev'd 7-99)
(PDF 19.5 KB)
Release of Information - Patient Waiver
(rev'd 11-04)
(PDF 52.7 KB)
Application
and Consent Order under 85.21
(rev'd 9-02)
(PDF 40 KB)
Agreement for Settlement
(rev'd 7-05)
(PDF 23 KB)
Compromise Case Settlement - 85.35(3)
rev'd 7-05)
(PDF 25 KB)
Contingent Settlement -
85.35(5) (rev'd 7-05)
(PDF 24.5 KB)
Combination Settlement -
85.35(4) (rev'd 7-05)
(PDF 32.5 KB)
Claimant's Statement
(rev'd 7-05)
(PDF 31.7 KB)
Payment Activity Report
(PAR) (rev'd 7-05)
(PDF 73 KB)
Copy/Information Request
(rev'd 7-05)
(PDF 31 KB)
Waiver for Release of Records
(rev'd 7-05)
(PDF 26 KB)
Fee Schedule for
Copy/Data Requests (rev'd 7-05)
(PDF 32 KB)
Charge Account Application
(rev'd 4-06)
(PDF 88 KB)
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