Form LS-204 Attending Physician's Supplementary Report

What Is Form LS-204?

This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on April 1, 2012 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 LS-204?
A: Form LS-204 is the Attending Physician's Supplementary Report.

Q: Who should complete Form LS-204?
A: The attending physician should complete Form LS-204.

Q: What is the purpose of Form LS-204?
A: The purpose of Form LS-204 is to provide additional medical information or updates related to a worker's injury or illness.

Q: Are there any deadlines for submitting Form LS-204?
A: The deadlines for submitting Form LS-204 may vary depending on the regulations of the workers' compensation agency. It is important to check the specific deadlines for your jurisdiction.

Q: Is completing Form LS-204 mandatory?
A: The requirement to complete Form LS-204 may vary depending on the regulations of the workers' compensation agency. It is important to check the specific requirements for your jurisdiction.

Q: What information should be included in Form LS-204?
A: Form LS-204 typically includes information about the worker's diagnosis, treatment plan, estimated return-to-work date, and any restrictions or limitations.

Q: Can Form LS-204 be used for both work-related injuries and illnesses?
A: Yes, Form LS-204 can be used for both work-related injuries and illnesses.

Q: Is Form LS-204 confidential?
A: The confidentiality of Form LS-204 may vary depending on the regulations of the workers' compensation agency. It is important to check the privacy and confidentiality policies of your jurisdiction.

Q: Can Form LS-204 be used for ongoing medical updates?
A: Yes, Form LS-204 can be used to provide ongoing medical updates as necessary.

Q: Is there a fee for submitting Form LS-204?
A: The fee requirements for submitting Form LS-204 may vary depending on the regulations of the workers' compensation agency. It is important to check the fee schedule for your jurisdiction.