Colorado
Workers Comp
Last updated: 8/17/2025
Application For Indigent Determination {WC35}
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Description
WC35 - APPLICATION FOR INDIGENT DETERMINATION (DIME). : You have the right to submit this application if you believe that you are unable to pay the fee(s) required to obtain a Division Independent Medical Examination (DIME). You must complete this Application and sign the affirmation on page four. The original Application shall be filed with the Division of Workers' Compensation Prehearings Unit at 633 17th St, Suite 400, Denver, CO 80202 and a copy sent to all parties in the case. www.FormsWorkflow.com
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