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Ga 200 Form 2011

Ga 200 Form 2011

Create, verify, and track a Ga 200 Form 2011 online using a ready-made template.

(b). Board Claim No. Employee Last Name Employee First Name M.I. SSN or Board Tracking # Date of Injury A. IDENTIFYING INFORMATION County of Injury Address EMPLOYEE E-mail Address City State Zip Code B. PHYSICIANS / TREATMENT Address 1. The currently authorized treating physician is Dr.: Name City State Zip Code State Zip Code Address 2. The Authorization is requested for treatment by Dr.: Name City 3. The additional treatment authorized is: C. AGREEMENT 1. The parties...
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Hello there my name is Jason Perkins, and I'd like to welcome you to another episode in my Georgia workers compensation video series I'm an attorney that specializes in Georgia workers compensation cases and in my Georgia workers compensation video series I provide you with helpful information about the rules of Georgia's workers compensation law and the benefits available to you under that law today I'm going to talk to you about a form that's published by the state board workers compensation called a form WC — 200 it's used to basically designate your authorized treating physician or to designate other medical treatments if you're in — I'll turn your case and there's actually two different forms one is a form when you agree about medical treatment and the second is when there's a disagreement, and you're going to request certain medical treatment, but before we jump into that in detail be sure and be on the lookout for an upcoming episode in this series about the form WC rickety

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