Audit Complaint Form {DWC-AU-906}

DWC-AU-906 - AUDIT COMPLAINT FORM. The Department of Industrial Relations, Division of Workers’ Compensation uses the information in your complaint (1) to monitor workers’ compensation claims administrators; (2) to assist DWC and other government agencies in general civil and criminal law enforcement; and (3) to conduct research on the workers’ compensation system. If you indicate that you want your complaint kept confidential, the Audit Unit will not share your complaint with any party named in your complaint. If you do not request confidentiality, the Audit Unit may share your complaint with the claims administrator. Please note that your complaint and your workers’ compensation claim information cannot be disclosed to the public under the Public Records Act. www.FormsWorkflow.com