Agreement For Settlement Under Iowa Code Section 85.35(2) {14-0021}

AGREEMENT FOR SETTLEMENT UNDER IOWA CODE § 85.35(2). This form is submitted to the Iowa Workers’ Compensation Commissioner for approval of a workers’ compensation settlement. It documents an agreement between an injured worker (claimant) and the employer/insurance carrier (defendants) regarding the injury, benefits, and settlement terms. The form includes details such as the date of injury, jurisdiction, compensation rate, type and duration of benefits paid, remaining compensation owed, medical care entitlement, and the total settlement amount. By signing, the claimant waives the right to a hearing and statutory benefits in exchange for the agreed settlement. The form must include supportive evidence, and if the claimant is unrepresented, a Claimant’s Statement must be attached. The settlement is subject to review-reopening for three years. It requires signatures from the claimant, their attorney (if applicable), the employer/insurer representative, and their attorney, along with notarization. www.FormsWorkflow.com