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How to use or fill out the DoL CA-16 online
Filling out the DoL CA-16 is a crucial step in the workers' compensation process, ensuring that medical services are authorized for injured employees. This guide offers step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to fill out the DoL CA-16
- Click 'Get Form' button to obtain the form and open it in your preferred document editor.
- In Part A, enter the name and address of the medical facility or physician authorized to provide medical services. Then, fill in the employee's name, date of injury, occupation, and describe the injury or disease.
- Review the authorization section, which allows medical care for up to sixty days. Confirm that you understand and agree to the conditions regarding payment and treatment.
- If applicable, obtain approval for any illnesses or diseases involved. Ensure to provide the name and title of the authorizing official along with their contact information.
- In Part B, enter the employee's name and document the history of the injury or disease provided by the employee. Note any pre-existing conditions if applicable.
- Record your findings, diagnosis, and indicate whether the condition was caused or aggravated by employment activities.
- Document any hospitalization required, including dates, and detail any surgical procedures if performed.
- Provide information about the type of treatment given, anticipated permanent effects, and dates of examinations and treatments.
- Indicate the employee's ability to resume work and detail any physical limitations or recommendations for future care.
- Finally, sign and date the form. Ensure all required fields are completed before submitting.
- Once completed, save changes, then download, print, or share the finalized form according to your needs.
Start filling out the DoL CA-16 online to facilitate the authorization of medical services today.
Get form
To get a CA form, you can start by visiting the official Department of Labor website or your company's HR department. Most organizations provide these forms to employees as part of their healthcare or injury protocols. If you're experiencing difficulty locating the CA form, uSlegalforms can provide resources and templates to guide you through the process. Using the right tools will make obtaining your necessary paperwork easier.
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