Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee's treating physician to initiate the utilization ...

This form must be submitted to the Workers' Compensation Board by mail, email or Axtarish Upload. Information can be found on the Forms page of the Board's website.

You may file this form (RFA-1W) and any attachments with the Workers' Compensation Board when you want the Board to take a specific action in your claim, or if ...

The requesting provider must complete: (1) the patient's name, date of birth, date of injury, employer, and claim number; (2) the claims administrator's name, ...

Routing Information: The DWC Form RFA can either be mailed or faxed together with the required reports to the claims administrator. The requesting provider ...

4 дек. 2023 г. · The Request for Further Action by Insurer/Employer (Form RFA-2) has been modified to better align with the process for resolving payer denials.

The RFA form typically includes sections for the employee to fill in details about the proposed action, the rationale behind it, the potential benefits, the ...

16 апр. 2017 г. · The rule works this way; the treating doctor requests treatment by using a required form, the Request for Authorization (RFA).

An updated form for the State of California Division of Workers' Compensation Request for Authorization for Medical Treatment (aka DWC Form RFA) was released ...

You may use this form for approving a treatment request. A request for additional information, or a decision to modify, delay, or deny a request for ...