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DWC-AD Form 102 Request for Summary Rating Determination of Primary Treating Physician Report - California
What Is DWC-AD Form 102?
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-AD Form 102?
A: DWC-AD Form 102 is a form used in California to request a summary rating determination of the primary treating physician report.
Q: Who can request a summary rating determination using DWC-AD Form 102?
A: Anyone involved in a workers' compensation case in California can request a summary rating determination using DWC-AD Form 102.
Q: What does a summary rating determination of the primary treating physician report involve?
A: A summary rating determination involves evaluating the medical report provided by the primary treating physician to determine the level of permanent disability for a workers' compensation case.
Q: Are there any fees for requesting a summary rating determination using DWC-AD Form 102?
A: No, there are no fees for requesting a summary rating determination using DWC-AD Form 102.
Form Details:
- Released on November 1, 2008;
- The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of DWC-AD Form 102 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-AD Form 102 Request for Summary Rating Determination of Primary Treating Physician Report - California
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