Attending Physician Report Form
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People also ask
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Who completes an attending physician's statement?
Have the appropriate doctor complete the APS. You may have multiple doctors treating you for different medical issues, not all relating to your disability. It is important that the doctor treating your disabling condition is the one completing the APS.
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What is a ca2 form used for?
The CA-2 Notice of Occupational Disease form should be used if you have sustained an occupational disease injury on the job. An Occupational Disease is a condition produced in the work environment over a period longer than one work day or shift.
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What is a CA20 form?
FORM CA-20, PHYSICIAN'S REPORT. Compensation for wage loss cannot be paid unless medical evidence has been submitted supponing disability for work during the period claimed.
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What is a CA 16 form?
Form CA-16 - Authorization for Examination and/or Treatment. This form guarantees payment to the care provider if the employee requires medical treatment because of a work-related traumatic injury. Your supervisor should complete page 1 of Form CA-16 and provide it to you for your attending physicians information.
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Who fills out a CA-16 form?
If an employee requires medical treatment for a traumatic injury, supervisor should complete front of Form CA-16, within four hours of request whenever possible. If supervisor doubts whether employee's condition is related to employment, he/she should so indicate on Form CA-16.
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What is a CA 17 form used for?
The CA-17 was designed to provide the doctor with an accurate description of the physical work requirements of the injured letter carrier. The CA-17 is a legal document that determines both an injured worker's medical restrictions and entitlement to wage-loss compensation benefits.
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What is a CA 17 form used for?
The CA-17 was designed to provide the doctor with an accurate description of the physical work requirements of the injured letter carrier. The CA-17 is a legal document that determines both an injured worker's medical restrictions and entitlement to wage-loss compensation benefits.
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When can CA-16 be issued?
(b) The Form CA-16 should be issued within four hours of the claimed injury. If the employer gives verbal authorization for such care, he or she should issue a Form CA-16 within 48 hours. The employer is not required to issue a Form CA-16 more than one week after the occurrence of the claimed injury.
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