Follow-Up DIME Forms
Form Name | Follow-Up DIME |
Form # | WC178 |
Form Revision | Rev 04/23 |
Category | Forms » Medical/Health |
Downloads | |
Form State | Colorado |
Language | English |
State Description | This form must be submitted when the claimant previously had a Division IME and was determined to be 'not at MMI', and the insurer/respondent is now requesting a follow-up IME. It may also be used on |
Claimwire Description | n/a |