DWC Form PR-4 Primary Treating Physician's Permanent and Stationary Report - California

DWC Form PR-4 Primary Treating Physician's Permanent and Stationary Report - California

What Is DWC Form PR-4?

This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DWC Form PR-4?
A: DWC Form PR-4 is the Primary Treating Physician's Permanent and Stationary Report in California.

Q: What is the purpose of DWC Form PR-4?
A: The purpose of DWC Form PR-4 is to provide a report on the injured worker's permanent and stationary condition.

Q: Who fills out DWC Form PR-4?
A: The primary treating physician fills out DWC Form PR-4.

Q: What information is included in DWC Form PR-4?
A: DWC Form PR-4 includes information on the injured worker's diagnosis, treatment, and current medical status.

Q: When should DWC Form PR-4 be completed?
A: DWC Form PR-4 should be completed when the injured worker's condition becomes permanent and stationary, meaning further medical improvement is unlikely.

Q: Are there any deadlines for submitting DWC Form PR-4?
A: Yes, DWC Form PR-4 must be submitted within 30 days of the injured worker becoming permanent and stationary.

Q: What happens after DWC Form PR-4 is submitted?
A: After DWC Form PR-4 is submitted, the claims administrator will review the report and determine the injured worker's eligibility for permanent disability benefits.

Q: Can DWC Form PR-4 be amended?
A: Yes, DWC Form PR-4 can be amended if there are changes to the injured worker's medical condition.

Q: Is DWC Form PR-4 confidential?
A: Yes, the information provided on DWC Form PR-4 is confidential and protected under privacy laws.

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Form Details:

  • Released on February 1, 2016;
  • The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • 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 DWC Form PR-4 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.

Download DWC Form PR-4 Primary Treating Physician's Permanent and Stationary Report - California

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