DWC Form 9783 Predesignation of Personal Physician - California

DWC Form 9783 Predesignation of Personal Physician - California

What Is DWC Form 9783?

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 9783?
A: DWC Form 9783 is the Predesignation of Personal Physician form in California.

Q: What is the purpose of DWC Form 9783?
A: The purpose of DWC Form 9783 is to allow employees in California to predesignate their personal physician or medical group in case of a work-related injury or illness.

Q: Who can use DWC Form 9783?
A: Any employee in California who has a work-related injury or illness can use DWC Form 9783 to predesignate their personal physician or medical group.

Q: How does predesignation work?
A: By completing DWC Form 9783 and submitting it to their employer, employees can predesignate their personal physician or medical group as their primary treating physician for any future work-related injury or illness.

Q: Is predesignation mandatory?
A: No, predesignation is not mandatory. It is an option for employees in California.

Q: Can an employer refuse the predesignated physician?
A: An employer can refuse the predesignated physician if certain conditions are not met, such as the physician's specialty not being appropriate for the employee's injury or illness.

Q: How often can an employee change their predesignated physician?
A: An employee can change their predesignated physician at any time and as often as they want by submitting a new DWC Form 9783 to their employer.

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Form Details:

  • Released on July 1, 2014;
  • The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • Easy to use and ready to print;
  • Available in Spanish;
  • 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 9783 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 9783 Predesignation of Personal Physician - California

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