DWC Form RFA, Request for Authorization, is a legal document filled out by the treating physician of the employee with a work-related injury or illness to request authorization of special medical treatment, services, and procedures.
The RFA Form must be given to the claims administrator or authorized agent of the utilization review organization in charge of the utilization review process. The claims administrator then reviews the request and determines if this treatment to an industrial injury or illness is medically necessary and appropriate. It is necessary to obtain preauthorization of non-emergency services by identifying recommended treatments and attaching documentation that substantiates the need for the treatment.
This form was released by the California Division of Worker's Compensation, a component of the California Department of Industrial Relations. The latest version of the form was issued on February 1, 2014, with all previous editions obsolete. You can download a fillable California RFA Form through the link below.