Use the form attached below to request a hearing before an Administrative Law Judge to appeal a decision issued pursuant to D.C. Code §§ 1-623.06a, 1-623.24(b) or 1-623.24(d) by the District of Columbia Public Sector Workers’ Compensation Program (PSWCP).
Visit the Filings & Forms page for instructions on how you can file your completed form with OAH.
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