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and the claimant requests an expedited hearing on compensability and medical benefits. (Attach a copy of the Notice of Contest). Section 8-43-203(1)(a), C.R.S.; or
, an authorized treating provider, and prior authorization has been denied. (Attach a copy of the recommendation of the authorized treating provider). The claimant requests an expedited hearing. Rule 16-10, WCRP; or
. The Respondents request an expedited hearing. (Attach a copy of the Petition and objection). Rule 6-4, WCRP.
The opposing party may file a response to this Application for Expedited Hearing within 10 days of the mailing or delivery of this Application for Expedited Hearing.
Witnesses to be called at the hearing or by deposition: List names and addresses:
I hereby certify that I mailed or delivered the original of the Application for Expedited Hearing to all parties at the addresses shown below (A claimant must provide a copy to the employer and the insurer, or their attorney):
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