What is a pr4 report?

A PR4 report is a final summary report that is required by the Division of California Workers' Compensation when a workers' injury results in "residual effects from the injury or may require future medical care".

What is a DWC Form RFA?

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.

What is an RFA in workers compensation?

A. An RFA is a form that the doctor is required to use to request treatment, diagnostic tests or other medical services for an injured worker. If the treatment request was first made verbally, it must be confirmed in writing.

Get CA DWC Form RFA 2014-2023

Treatment should also be included. For requested treatment that is: (a) inconsistent with the Medical Treatment Utilization Schedule (MTUS) found at California Code of Regulations, title 8, section 9792.20, et seq.; or (b) for a condition or injury not addressed by the MTUS, you may include scientifically based evidence published in peer-reviewed, nationally recognized journals that recommend the specific medical treatment or diagnostic services to justify your request. Requesting Physician Sig.

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