Iowa
Workers Compensation
200 Ratings
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Last updated: 9/20/2023
Claimants Statement {14-0163}
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Description
Form 14-0163 - CLAIMANT'S STATEMENT. The Iowa Division of Workers’ Compensation (DWC) requires a claimant who is not represented by counsel to attach this completed and signed form with any proposed settlement documents. DWC will use the information you give on this form when considering your proposed settlement. www.FormsWorkflow.com
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