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This version of the form is not currently in use and is provided for reference only. Download this version of
Form CM-787
for the current year.
Form CM-787 Physician's / Medical Officer's Statement
What Is Form CM-787?
This is a legal form that was released by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation on April 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form CM-787?
A: Form CM-787 is a Physician's/Medical Officer's Statement.
Q: What is the purpose of Form CM-787?
A: The purpose of Form CM-787 is to provide medical information about a patient.
Q: Who fills out Form CM-787?
A: A physician or medical officer fills out Form CM-787.
Q: What information should be included in Form CM-787?
A: Form CM-787 should include the patient's medical condition, diagnosis, treatment plan, and any limitations or restrictions.
Form Details:
- Released on April 1, 2018;
- The latest available edition released by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CM-787 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Division of Coal Mine Workers' Compensation.
Download Form CM-787 Physician's / Medical Officer's Statement
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