Form WC77 Notice and Proposal and Application for a Division Independent Medical Examination (Dime) - Colorado

Form WC77 Notice and Proposal and Application for a Division Independent Medical Examination (Dime) - Colorado

What Is Form WC77?

This is a legal form that was released by the Colorado Department of Labor and Employment - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is WC77?A: WC77 is a Notice and Proposal and Application for a Division Independent Medical Examination (DIME) in Colorado.

Q: What is the purpose of WC77?A: WC77 is used to request a Division Independent Medical Examination (DIME) in Colorado for workers' compensation cases.

Q: When do I need to file WC77?A: You need to file WC77 within 30 days after receiving the final admission of liability or final order of the administrative law judge.

Q: How do I file WC77?A: You can file WC77 by completing the form, signing it, and sending it to the Division of Workers' Compensation.

Q: Who can request a DIME using WC77?A: The injured worker, the employer, or the workers' compensation insurance carrier can request a DIME using WC77.

Q: What happens after filing WC77?A: After filing WC77, the Division of Workers' Compensation will schedule the DIME and notify all parties involved.

Q: Can I choose the DIME physician?A: No, the DIME physician is selected by the Division of Workers' Compensation.

Q: What is the cost of a DIME?A: The cost of a DIME is typically paid by the party requesting the examination.

Q: What is the purpose of a DIME?A: A DIME is conducted to resolve disputes regarding the extent of impairment, maximum medical improvement (MMI), and related issues in workers' compensation cases.

Q: What should I bring to the DIME?A: You should bring any medical records, diagnostic tests, or other relevant documents to the DIME appointment.

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Form Details:

  • Released on October 1, 2018;
  • The latest edition provided by the Colorado Department of Labor and Employment;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form WC77 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Colorado Department of Labor and Employment.

Download Form WC77 Notice and Proposal and Application for a Division Independent Medical Examination (Dime) - Colorado

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