Form 9783 Predesignation of Personal Physician - California

What Is Form 9783?

This is a legal form that was released by the California Department of Industrial Relations - 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 Form 9783?A: Form 9783 is the Predesignation of Personal Physician form.

Q: What is the purpose of Form 9783?A: The purpose of Form 9783 is to allow workers in California to select their personal physician for workers' compensation medical treatment.

Q: Who can use Form 9783?A: Form 9783 can be used by workers in California who want to predesignate their personal physician for workers' compensation cases.

Q: What information is required on Form 9783?A: Form 9783 requires the worker's personal information, their chosen personal physician's information, and the worker's signature.

Q: Who should I submit Form 9783 to?A: Form 9783 should be submitted to your employer or the insurance company handling your workers' compensation claim.

Q: Is there a deadline for submitting Form 9783?A: Yes, Form 9783 must be submitted to your employer or insurance company within 30 days of starting your employment.

Q: Can I change my predesignated personal physician?A: Yes, you can change your predesignated personal physician by submitting a new Form 9783 to your employer or insurance company.

Q: What if I don't predesignate a personal physician?A: If you don't predesignate a personal physician, your employer or their workers' compensation insurance will provide you with a medical provider.

Q: Can my employer refuse my predesignated personal physician?A: In most cases, your employer cannot refuse your predesignated personal physician if certain conditions are met, such as the physician being your primary treating physician for at least three years.