DWC-AD Form 104 Request for Consultative Rating - California

What Is DWC-AD Form 104?

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 104?
A: DWC-AD Form 104 is a form used to request a consultative rating in California.

Q: What is a consultative rating?
A: A consultative rating is an evaluation of a workers' compensation claim to determine the level of permanent disability.

Q: Who can request a consultative rating?
A: Any party involved in a workers' compensation claim in California can request a consultative rating, including the injured worker, the employer, or the insurance company.

Q: How do I fill out DWC-AD Form 104?
A: You need to provide information about the injured worker, the claim, and the specific issues you want the consultative rating to address.

Q: Is there a fee for requesting a consultative rating?
A: Yes, there is a fee associated with requesting a consultative rating. The fee amount may vary.

Q: What happens after I submit DWC-AD Form 104?
A: After you submit the form, the DWC will review the request and schedule a consultative rating evaluation.

Q: How long does it take to get a consultative rating?
A: The time it takes to get a consultative rating can vary, but it typically takes several weeks to several months.

Q: Can I appeal a consultative rating decision?
A: Yes, you have the right to appeal a consultative rating decision if you disagree with the outcome.

Q: Who should I contact if I have questions about DWC-AD Form 104?
A: If you have questions about DWC-AD Form 104, you can contact the California Division of Workers' Compensation (DWC) for assistance.