Hawaii WC-36 vs. WC-77: Filing the Hearing Request Form

The Hawaii WC-36 workers’ compensation form is not something an injured worker can fill out. The Hawaii Department of Labor and Industrial Relations restricts WC-36 to insurance carriers, who submit it through a portal, and the form is not available for public download.¹ If you came here because you want to contest a denied claim or disputed benefits, the form you actually need is WC-77, Application for Hearing, which is freely available from the Disability Compensation Division (DCD) and is what injured employees file to open a dispute.

Why WC-36 Keeps Getting Confused With the Hearing Form

Several online sources describe WC-36 as the “Application for Hearing” that workers use to challenge denials. That is wrong. The DLIR’s own forms page lists WC-36 as carrier-only and tells anyone with questions about it to contact their insurance carrier directly.¹ The form’s specific role inside the carrier’s workflow is not publicly documented. For the injured worker, none of that matters. What matters is that the right form has a different number, and the rest of this guide walks through it.

What Form WC-77 Does

WC-77 is how you ask the DCD to hold a formal hearing on an unresolved workers’ compensation issue. Either party in a claim can request one when a matter can’t be settled informally.² For workers, the typical reasons to file are:

The carrier denied the entire claim, arguing the injury didn’t arise from work.
Temporary Total Disability (TTD) payments were cut off before you recovered. TTD is paid at two-thirds of your average weekly wages after a three-day waiting period, with a 2026 maximum of $1,240 per week.³⁴
You disagree with the Permanent Partial Disability (PPD) rating assigned by the carrier’s physician. Ratings drive the number of weeks of benefits you receive under Hawaii’s statutory schedule — loss of a hand equals 244 weeks, loss of an arm equals 312 weeks — so a low rating can cost tens of thousands of dollars.⁵
The carrier refused to authorize a surgery, specialist referral, or your choice of treating physician.

How to Fill Out WC-77

The identifying portion of the form is straightforward: your name, your employer’s name, the insurance carrier, the date of injury, and the DCD case number assigned when your claim was first opened. The sections that actually decide the hearing are the ones asking you to state the issues in dispute and the relief you want.

Be specific. Instead of writing “I want my benefits paid,” list the exact periods of TTD that went unpaid, name each medical treatment that was denied, or state the PPD rating you believe is correct and why. If you have supporting medical evidence — a report from your treating physician, an independent medical examination — identify it on the form. Hearings officers rely heavily on medical documentation, and flagging it up front strengthens the filing.

Where to File

File WC-77 at the DCD office that serves your island, and send a copy to your employer or its insurance carrier so they have notice of the request. Office contacts are listed on the DCD website:⁶

Oahu: (808) 586-9161
Hilo: (808) 974-6464
Kona: (808) 322-4808
Maui: (808) 984-2702
Kauai: (808) 274-3351

On the neighbor islands, file at the nearest DLIR district office.

Deadlines You Can’t Miss

Hawaii workers’ compensation runs on short clocks, measured from the date a decision is sent, not the date you receive it.

You have 20 calendar days after a preliminary decision is sent to file a written hearing request. Miss it and the preliminary decision becomes final.⁷
You have 20 calendar days from the date stamped on a hearings officer’s decision to file a written notice of appeal with the DLIR.²
A closed case can be reopened within 20 days for newly discovered evidence, at any time for fraud, and for up to eight years after the last compensation payment or claim rejection if your physical condition has changed.⁸

If a deadline is close, file first and add supporting documents afterward.

What Happens After You File

DCD hearings are informal. They aren’t governed by the Hawaii Administrative Procedure Act, and no stenographic or tape recording is permitted.⁹ Think of it as a structured meeting where each side presents facts and documents to the hearings officer. If you don’t show up, the officer can decide the matter on the existing file, which effectively forfeits your chance to add new evidence.⁷

A written decision must be issued within 60 days after the hearing concludes, with findings of fact and conclusions of law. Both parties can agree to extend that deadline for good cause.⁹

If you disagree with the decision, you can appeal within 20 days to the Labor and Industrial Relations Appeals Board (LIRAB), which holds a full new hearing on the case rather than a review of what happened below.¹⁰ LIRAB proceedings are more formal, and the board also offers voluntary settlement conferences to see whether a case can resolve before trial.¹¹

Hiring an Attorney

You can hire an attorney for any stage of a workers’ compensation dispute, but every fee arrangement must be approved by the director, the appeals board, or the reviewing court. Collecting an unapproved fee exposes the attorney to a fine of up to $25,000. When fees are set, the reviewing authority weighs the attorney’s experience in Hawaii workers’ compensation cases, the complexity of the issues, the time and effort involved, fees in comparable cases, the benefits obtained, and the customary hourly rate for similar work. All approved fees must be reasonable, and they attach as a lien on the compensation award, so in most cases they come out of your benefits rather than your pocket.¹²

1
Disability Compensation Division. Disability Compensation Division Forms
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Hawaii Department of Labor and Industrial Relations. About Workers’ Compensation (WC)
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Justia. Hawaii Code 386-31 – Total Disability
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Hawaii Department of Labor and Industrial Relations. 2026 Maximum Weekly Wage Base and Maximum Weekly Benefit Amount
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Justia. Hawaii Code 386-32 – Partial Disability
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Disability Compensation Division. Frequently Asked Questions
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Hawaii Department of Labor and Industrial Relations. Hawaii Administrative Rules Chapter 12-10 – Workers Compensation
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Justia. Hawaii Code 386-89 – Reopening of Cases; Continuing Jurisdiction of Director
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Justia. Hawaii Code 386-86 – Proceedings Upon Claim; Hearings
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Justia. Hawaii Code 386-87 – Appeals to Appellate Board
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Labor and Industrial Relations Appeals Board. FAQs – Work Comp
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Justia. Hawaii Code 386-94 – Attorneys, Physicians, Other Health Care Providers, and Other Fees