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Form DWC-40 Request for Additional Palliative Care - Rhode Island
What Is Form DWC-40?
This is a legal form that was released by the Rhode Island Department of Labor and Training - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form DWC-40?A: Form DWC-40 is the Request for Additional Palliative Care form in Rhode Island.
Q: What is the purpose of form DWC-40?A: The purpose of form DWC-40 is to request additional palliative care in Rhode Island.
Q: Who can use form DWC-40?A: Patients or their authorized representatives can use form DWC-40 to request additional palliative care in Rhode Island.
Q: Is there a fee for submitting form DWC-40?A: No, there is no fee for submitting form DWC-40 in Rhode Island.
Q: How should I submit form DWC-40?A: Form DWC-40 should be completed and submitted to the Rhode Island Workers' Compensation Court.
Q: Is there a deadline for submitting form DWC-40?A: Yes, form DWC-40 should be submitted as soon as possible but no later than 30 days before the planned initiation of additional palliative care.
Q: What information is required on form DWC-40?A: Form DWC-40 requires information such as the patient's name, contact information, medical provider's information, and details about the requested additional palliative care.
Q: Can I appeal a denial of my request on form DWC-40?A: Yes, if your request on form DWC-40 is denied, you have the right to appeal the denial.
Q: Who should I contact for more information about form DWC-40?A: For more information about form DWC-40, you can contact the Rhode Island Workers' Compensation Court.
Form Details:
- Released on April 1, 2005;
- The latest edition provided by the Rhode Island Department of Labor and Training;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DWC-40 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Rhode Island Department of Labor and Training.
