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The document is a form (Form 9-A) issued by the Office of Risk Management in the District of Columbia, designed for individuals to appeal decisions made by the Public Sector Workers’ Compensation Program. It outlines the appeal process, including deadlines, required information, and submission instructions. The form requires details about the claimant, representative (if any), nature of the appeal, reasons for disagreement with the decision, and specific requests to the Chief Risk Officer.

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Versions	Form popularity	Fillable & printable
2019	4.2 Satisfied (55 Votes)
2017	4.6 Satisfied (55 Votes)
2016	4.5 Satisfied (50 Votes)

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