Free DWC Form 113 Template – Denial of Time Extension Form
Free DWC Form 113 Template – Denial of Time Extension Form
Download a free Denial of Time Extension (DWC Form 113) template to officially notify parties of denied extension requests in California workers' compensation cases.
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The Denial of Time Extension (DWC Form 113) is an official form used in California workers' compensation cases to notify all parties involved in the case when a Qualified Medical Evaluator (QME) has requested additional time to submit their medical-legal report, but the request has been denied by the Division of Workers' Compensation (DWC). This form ensures transparency and timely processing of medical evaluations within the workers’ compensation system.
Significance of DWC Form 113

The Notice of Denial of Request for Time Extension has the following vital purposes:

  • Notifies the denial of time extension: It informs all involved parties that the QME’s request for additional time has been rejected.
  • Ensures compliance: The form helps maintain timelines set by California workers’ compensation regulations.
  • Clarifies what to do next: It guides parties on how to proceed after a denied time extension request.
Key Information Included in DWC Form 113

The Denial of Time Extension (Form 113) contains important details such as:

  • Claimant and QME details
  • Original due date of the report
  • Reason for denial of extension
  • Instructions for next steps
Why Is This Form Important?

Timely submission of QME reports is crucial in workers' compensation cases to:

  • Ensure smooth claims processing and avoid unnecessary delays.
  • Provide critical medical opinions for determining benefits.
  • Maintain compliance with California's workers' compensation regulations.
Download the DWC Form 113 Template for Free
Get a free Denial of Time Extension template to handle QME timelines and compliance with confidence.