Publications and Forms
Questions and affidavit for claimant regarding completeness of medical information submitted, form E.
A form for use by health care provider to determine case status information to file a medical fee dispute application.
A request by an employer or insurer for an award on undisputed facts in regard to application for a direct payment medical fee dispute.
A form for use by a health care provider requesting the dismissal of an application for direct payment in a workers’ compensation medical fee dispute.