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LWC FORM 1010 - REQUEST OF AUTHORIZATION/CARRIER OR SELF INSURED EMPLOYER RESPONSE PLEASE PRINT OR TYPE SECTION 1. IDENTIFYING INFORMATION - To Be Filled Out By Health Care Provider First: Middle:.

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Under Louisiana law and as outlined in Form LWC-WC 1121, an employee that is injured at work or becomes sick due to something that happened while on the job has the right to choose his or her own doctor, in any field or specialty of medicine, for medical care and treatment.

The First Report of Injury (Form LWC-WC IA-1) is a legal form released by the Louisiana Workforce Commission - a government authority operating within Louisiana. Louisiana Law requires that employers complete the form within 10 days of actual knowledge of the incident.

The health care provider seeking authorization to exceed the $750 statutory limit for medical services must submit a request for such authorization to the employer or its workers compensation insurer on an Form LWC-WC 1010 (Request of Authorization/Carrier or Self Insured Employer Response).

A provider must submit a Form 1010 to the insurer requesting authorization to continue treating the injured worker once the initial $750 limit on nonemergency care has been reached.

Form IA-1 Employer's First Report of Injury or Occupational Disease (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of a work-related injury. Fatalities must be reported within 24 hours.

Louisiana Workers Comp Time Limit In Louisiana workers compensation, an injured worker must report his or her accident or injury to the employer within 30 days of the day that it occurs, or else the worker's right to recover workers compensation benefits may expire.

Simply fill out the Louisiana Workforce Commission's Office of Workers' Compensation's First Report of Injury or Illness (Form LWC-WC-IA-1) and email the report to onlineclaims@lwcc.com. An LWCC claims service professional will then call you within 24 hours to discuss the injury.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232