Any person may file a petition with the workers' compensation commissioner for a declaratory order as to the applicability to specified circumstances of a statute, rule, or order within the primary jurisdiction of the workers' compensation commissioner, at the office of the workers' compensation commissioner. Parties shall not use WCES for declaratory order proceedings. A petition is deemed filed when it is received by that office. The workers' compensation commissioner shall provide the petitioner with a file-stamped copy of the petition if the petitioner provides the agency an extra copy for this purpose. The petition must be typewritten or legibly handwritten in ink and must substantially conform to the following form:
Click here to view Image
The petition must provide the following information:
1. A clear and concise statement of all relevant facts on which the order is requested.2. A citation and the relevant language of the specific statutes, rules, policies, decisions, or orders, whose applicability is questioned, and any other relevant law.3. The questions petitioner wants answered, stated clearly and concisely.4. The answers to the questions desired by the petitioner and a summary of the reasons urged by the petitioner in support of those answers.5. The reasons for requesting the declaratory order and disclosure of the petitioner's interest in the outcome.6. A statement indicating whether the petitioner is currently a party to another proceeding involving the questions at issue and whether, to the petitioner's knowledge, those questions have been decided by, are pending determination by, or are under investigation by, any governmental entity.7. The names and addresses of other persons, or a description of any class of persons, known by petitioner to be affected by, or interested in, the questions presented in the petition.8. Any request by petitioner for a meeting provided for by rule 876-5.7 (17A). The petition must be dated and signed by the petitioner or the petitioner's representative. It must also include the name, mailing address, and telephone number of the petitioner and petitioner's representative and a statement indicating the person to whom communications concerning the petition should be directed.
Iowa Admin. Code r. 876-5.1
Amended by IAB July 31, 2019/Volume XLII, Number 3, effective 7/10/2019