Form DC-119 Physician / Health Care Provider Report - Maryland

What Is Form DC-119?

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

FAQ

Q: What is Form DC-119?
A: Form DC-119 is the Physician/Health Care Provider Report used in Maryland.

Q: Who needs to fill out Form DC-119?
A: Form DC-119 needs to be filled out by physicians or health care providers in Maryland.

Q: What is the purpose of Form DC-119?
A: The purpose of Form DC-119 is to provide medical information about an individual's health condition.

Q: What information is required on Form DC-119?
A: Form DC-119 requires information such as the patient's personal details, medical history, diagnosis, and treatment plan.

Q: How should Form DC-119 be submitted?
A: Form DC-119 should be submitted by mail or fax to the Maryland Workers' Compensation Commission.

Q: Are there any fees associated with submitting Form DC-119?
A: No, there are no fees associated with submitting Form DC-119.

Q: Are there any deadlines for submitting Form DC-119?
A: Yes, Form DC-119 should be submitted within 30 days from the date of request.

Q: Can Form DC-119 be filled out electronically?
A: Yes, Form DC-119 can be filled out electronically if the physician or health care provider has access to the necessary software.