Get Medical Eye Report

Completing the Medical Eye Report online is a straightforward process that ensures the accurate reporting of eye injuries. This guide provides step-by-step instructions to help you navigate the form effectively and efficiently.

Follow the steps to accurately complete your Medical Eye Report.

1. Press the ‘Get Form’ button to access the Medical Eye Report and open it in your online editor.
2. Begin by providing the WSCC claim number, if applicable. This helps link your report with other relevant case documentation.
3. Fill in the health care provider's name in the designated field. Ensure it is printed clearly for easy identification.
4. Enter the worker's information, including their last name, first name, and mailing address, along with their community and telephone number.
5. Include the worker's residential address, date of birth, employer’s name, and social insurance number as required.
6. Indicate the part of the body injured and the date of injury. Provide accurate details to ensure proper processing.
7. Answer the inquiry about whether you would like a WSCC doctor to contact you by selecting 'Yes' or 'No'.
8. Document who rendered the first treatment, including the date of that treatment.
9. Specify which eye was injured by selecting 'Right' or 'Left'.
10. Provide the visual acuity of both the right and left eye as determined during the first examination.
11. Describe what the worker reported as the cause of the injury.
12. Note the findings during the examination and indicate the location and extent of the injury on the provided diagram.
13. Outline any treatment that was administered.
14. Indicate whether there is any evidence of previous disease or injury in either eye and provide details if applicable.
15. State if you expect any complications from the current injury and supply an explanation if necessary.
16. Assess whether permanent disability is probable and mark your response.
17. Report the current work ability status of the worker, choosing from the options available, and specify the duration of modified duties if applicable.
18. Finally, add your signature as a healthcare professional, certifying the information entered on the report is accurate.
19. Upon completion, save any changes made to the document, and then opt to download, print, or share the Medical Eye Report as needed.

Start completing your Medical Eye Report online today!