Get 14b Form

Filling out the 14b Form, or Physician’s Statement, is a crucial step for individuals seeking to address medical treatment issues associated with workplace injuries. This guide will provide you with clear, step-by-step instructions on how to effectively complete the form online.

Follow the steps to fill out the 14b Form online correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully read the instructions provided on the form to understand its purpose and the information required.
3. Begin with the claimant’s information section. Enter the full name, contact details, and any relevant case identifiers.
4. In the next section, provide the treating physician's information. This includes their name, medical license number, and contact details.
5. Specify whether future medical care and treatment will be required for the claimant's injury. Be precise in your assessment to ensure accuracy.
6. If applicable, detail any determined restrictions on the claimant due to their injury. This information is vital for decision-making regarding their care.
7. Complete the impairment rating section, where the treating physician must assess and report the level of impairment resulting from the injury.
8. Sign and date the form, ensuring that all signed individuals have the authority to provide the indicated details.
9. Once the form is completed, review all information for accuracy and clarity. Make sure there are no missing fields.
10. Finally, save your changes, download the form, print it if needed, or share it according to your submission requirements.

Complete your documents online today to ensure timely submission and processing.