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Code of Regulations, title 8, section 9785. This form must accompany the Doctor s First Report of Occupational Injury or Illness, Form DLSR 5021, a Treating Physician s Progress Report, DWC Form PR-2, or narrative report substantiating the requested treatment. New Request Resubmission Change in Material Facts Expedited Review: Check box if employee faces an imminent and serious threat to his or her health Check box if request is a written confirmation of a prior oral request. Employee I.

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Radiofrequency ablation (RFA) is a minimally invasive treatment, one of several types of ablation therapy, where surgery is not a good option. Guided by imaging, a thin needle or probe is inserted through the skin and into the tumor.

Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee's treating physician to initiate the utilization review process required by Labor Code section 4610.

Definition of Request for authorizationRequest for authorization means any request by a physician for assurance that appropriate payment will be made for a course of proposed medical treatment, including surgery or hospitalization, or any diagnostic studies beyond plain X-rays. Sample 2.

Form DWC 7 Instructions. DWC 7 Form Instructions. The California Workers' Compensation Notice to Employees Injuries Caused By Work Poster, otherwise known as CA DWC 7 form, must be posted in English and Spanish at all California locations.

Q. What is utilization review (UR) and why is it used for workers' compensation? A. UR is the process used by employers or claims administrators to determine if a proposed treatment requested for an injured worker is medically necessary.

Treating physicians are required to submit a complete and compliant Request for Authorization (RFA) for treatment. Regulation 9792.6. 1 defines Request for Authorization as a written request for a specific course of proposed medical treatment.

Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee's treating physician to initiate the utilization review process required by Labor Code section 4610.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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