Form WC189 Authorization for Release of Information - Colorado

What Is Form WC189?

This is a legal form that was released by the Colorado Department of Labor and Employment - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form WC189?
A: Form WC189 is an Authorization for Release of Information specifically for the state of Colorado.

Q: What is the purpose of Form WC189?
A: The purpose of Form WC189 is to obtain the authorization of an injured worker to release their medical information to the workers' compensation insurance carrier.

Q: Who needs to fill out Form WC189?
A: The injured worker needs to fill out Form WC189.

Q: Is Form WC189 specific to Colorado?
A: Yes, Form WC189 is specific to the state of Colorado and may not be applicable in other states.

Q: What information is required on Form WC189?
A: Form WC189 requires the injured worker's name, address, date of injury, and the information of the medical provider they authorize to release the information to.

Q: How should Form WC189 be submitted?
A: Form WC189 should be submitted to the workers' compensation insurance carrier.

Q: Is there a fee associated with submitting Form WC189?
A: No, there is no fee associated with submitting Form WC189.

Q: Can Form WC189 be revoked?
A: Yes, the injured worker can revoke an Authorization for Release of Information by submitting a written revocation to the workers' compensation insurance carrier.

Q: What happens after submitting Form WC189?
A: After submitting Form WC189, the workers' compensation insurance carrier can access the authorized medical information to process the workers' compensation claim.