Get Ca Imc 1002 1995-2025

The CA IMC 1002 form is an essential document used for summarizing medical findings in workers' compensation cases. This guide will help users navigate the online filling process effectively and ensure that all required information is accurately captured.

Follow the steps to complete the CA IMC 1002 online.

1. Click the ‘Get Form’ button to access the form and open it in the editor.
2. In the employee information section, enter the full name of the employee, including the first, middle, and last names. Fill in their street address, city, zip code, and telephone number. Additionally, include the date of injury in the specified format (month/day/year).
3. In the claims administrator/employer section, provide the name of the claims administrator or employer and complete their street address, city, zip code, and telephone number.
4. Proceed to the exam referral schedule section, where you need to fill in the date the appointment was scheduled, the date of the initial examination, the date of referral for medical testing or consultation, and the date the report was served on all parties.
5. In the disputed medical issues and conclusions section, check the appropriate boxes for each medical issue related to the employee. Reference the relevant page numbers or sections from the medical-legal report that contain further details.
6. Complete the basis for conclusions section by checking the relevant boxes and providing page numbers or section information from the medical-legal report. Additionally, summarize the diagnoses in lay terms and list any other physicians consulted.
7. Finally, ensure that the form is signed with the name of the qualified medical evaluator or agreed medical evaluator, including their specialty, street address, city, zip code, telephone number, and California license number.
8. Review all entries for accuracy, then save your changes, and choose to download, print, or share the completed form as necessary.

Complete your documents online today for a smooth filing experience.