Request For Setting
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Request For Setting (Application To Workers Compensation Judge) Form. This is a New Mexico form and can be use in Workers Compensation.
Tags: Request For Setting (Application To Workers Compensation Judge), New Mexico Workers Compensation,
STATE OF NEW MEXICO WORKERS222 COMPENSATION ADMINISTRATION , WCA No.: Worker, v. , and , Employer/Insurer. REQUEST FOR SETTING 1.WCA Judge assigned: 2.Are any other hearings currently set? Yes NoIf yes, please indicate the date of the hearing: 3.Specific matter to be heard: 4.Time required for hearing: 5.Is an interpreter required? Yes No(Employer/Insurer is responsible for making arrangements for the interpreter.)6.Is telephonic appearance being requested? Yes No(Employer/Insurer is responsible for arranging the conference call.) Signature Print name Address City/State/Zip Telephone E-mail address for service American LegalNet, Inc. www.FormsWorkFlow.com