Get Ime

This guide provides comprehensive instructions on how to complete the Ime online. It is designed to assist users in filling out the form accurately and efficiently, ensuring compliance with the Iowa Workers' Compensation Commissioner's requirements.

Follow the steps to successfully fill out the Ime online.

1. Press the ‘Get Form’ button to access the document and open it in your editing application.
2. Begin by filling in the claimant's name on the form at the top, followed by the employer's name and address. Ensure you provide complete and accurate information.
3. Enter the file number, which is typically assigned to your case, in the designated field on the form.
4. In the Original Notice section, confirm the address of the employer, including the city, state, and zip code.
5. Fill in the injury date, and specify the body part(s) that were injured, as this information is crucial for the evaluation process.
6. Proceed to the petition section, where the claimant must request an independent medical evaluation. Fill out the physician's name, examination date, and examination location.
7. Follow the provided context to fill in details about the injury, including the date of the incident, city, county, and a statement regarding the evaluation of permanent disability.
8. Ensure that the claimant's signature and the date signed are provided at the bottom of the petition section.
9. If represented by an attorney, include their name, address, and contact information, ensuring to denote the attorney’s signature.
10. Complete the proof of service section by indicating the date and name of the employer's last known address to which you mailed the original notice.
11. Fill out the answer section for the employer/insurance carrier, admitting or denying the allegations as necessary, and include their representative's signature and details.
12. Before finalizing, review the entire form for accuracy and completeness. Save your changes and ensure that documents such as the physician’s report are attached.
13. Once finalized, you can download, print, or share the form as per your needs.

Start completing the Ime online today to ensure a thorough and efficient filing process.