Authorization For Release Of Information Regarding Claimant Seeking WC Benefits {14-0043}

Form 14-0043 - AUTHORIZATION FOR RELEASE OF INFORMATION REGARDING CLAIMANT SEEKING WORKERS' COMPENSATION BENEFITS. Iowa Code section 85.27(2) and Iowa Administrative Code rule 876 — 8.9 require the release of information relating to an employee’s physical or mental condition relative to a workers’ compensation claim. Iowa Administrative Code rule 876 — 4.6 requires the claimant to serve a patient’s waiver on the defendant(s) concurrently with an original notice and petition, and to update the waiver as necessary. This form may be used in claims under the jurisdiction of the Iowa Workers’ Compensation Commissioner to satisfy the requirements for a claimant seeking workers’ compensation benefits to release information. www.FormsWorkflow.com