Document Number: WKC-28-DHA
Description: This form is to be used by a party to appeal a DHA administrative law judge's order to the Labor and Industry Review Commission.
Comments: This form is not fill-enabled. It can be printed and completed by hand. A petition to LIRC can also be filed electronically through http://lirc.wisconsin.gov/wc_appeal.htm.
Content Contact: Lynn Weinberger
Document Attachment: WKC-28-DHA (pdf/75 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.