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Document Number: WKC-19-DHA-E
Description: This DHA form is to be filed by the respondent insurer or employer in response to an Application for Hearing. The answer should be filed with the department and copied to the party who filed the application.
Comments: This form is an electronic Microsoft Word template that can be filled out on your computer (if you have Microsoft Word). An electronic PDF (WKC-19-DHA-E) is also provided for your convenience.
Content Contact: Lynn Weinberger
Document Attachments:
WKC-19-DHA-E (Electronic Version - Word/85 KB)
WKC-19-DHA-E (Electronic Version - pdf/736 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
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