Find the Right California Workers' Comp Form
Throughout the course of any Workers’ Compensation case, an injured worker will receive a wide variety of forms, regarding everything from medical treatment to financial benefits. It is extremely important to read the forms carefully, and contact an attorney to confirm what action, if any, needs to be taken. Keep in mind that many of these forms include strict timelines that must be met.
Sample Benefit Letters – Delay, Deny, AcceptDownload Form
After an Employee Claim Form is filed, within 14 days an injured worker is to receive a benefit letter accepting, rejecting, or delaying the determination of the claim. If delayed, then within 90 days the injured worker is to receive a benefit letter accepting or rejecting some, or all, of the claim.
If an insurance company fails to issue a letter within 90 days, then pursuant to Labor Code Section 5402 the claim is presumed to be accepted and there are certain rights afforded the injured worker in the case going forward.
|Sample Determination of Independent Medical Review (IMR)||Download Sample Letter|
|Sample Medical Authorization Letter and Form||Download Sample Letter|
|Sample Notice of Assignment of Independent Medical Review (IMR)||Download Sample Letter|
|Sample Denial Letter||Download Sample Letter|