Workers' Compensation Law Center represents employees who have sustained injuries through their employment. Our focus is providing superior service to our clients in a range of industries.
WORKERS' COMPENSATION FORMS
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Our Redding workers' compensation lawyers are ready to evaluate your specific case and work for the assistance you need to cover. Call us at (530) 222-9700 or e-mail us to schedule a free initial consultation.
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                                       We specialize in Workers' Compensation in Redding, Eureka, Crescent City, and Susanville, CA
The information you obtain at this site is not, nor is it intended to be, legal advice, nor does it establish an attorney-client relationship.                                                        You should consult an attorney for individual advice regarding your own situation.
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HURT AT WORK? WE CAN HELP.
As part of your workers compensation claim, you are entitled to reimbursement for the miles you drive to attend a medical, chiropractic, or other treatment related appointment, drop-off/pick-up a prescription, or attendance at a deposition.

In order to receive reimbursement, you must keep a log of the miles driven. To ensure prompt payment, it is recommended you utilize the DWC's mileage form.

Once you have filled out the medical mileage form, submit it directly to your workers compensation insurance carrier, specifically to the adjuster. Prior to mailing the form, make sure to make a copy for your records.

Medical Mileage Forms​​

​(The carrier has 60 days to pay mileage upon receiving the medical mileage form. Should the carrier fail to pay within this time, penalties can be awarded by the Workers Compensation Appeals Board.​​​)
As part of your workers compensation claim, you will need medical treatment. As of July 2013, all medical treatment requested by your Primary Treating Physician is to be on a Request For Authorization (RFA) form. Please verify with your PTP he/she has this form.

Request for Authorization Form

​(This form should be used in requesting medical treatment by your Primary Treating Physician.)
Other Forms