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Replace List into the Working Time Control Form

Replace List into the Working Time Control Form

Aug 6th, 2022

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Got questions?

Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.

Where do I mail my replacement panel request?

For Employee: Mail the completed signed form and Proof of Service to: Division of Workers Compensation Medical Unit P.O. Box 71010, Oakland, CA 94612 (510) 286-3700 or (800) 794-6900 5.

What is a DWC 7 form?

DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers compensation benefits and the Medical Provider Network (MPN) in California.

How do I get a QME panel?

You must have given your employer or the claims administrator a claim form before you may get a QME or any benefits. Answer all of the questions on QME form 105, sign the form and mail it to the DWC Medical Unit. The DWC Medical Unit will use the information on the form to issue a QME panel.

What is the Labor Code 4062 panel request?

Finally, Labor Code Section 4062 [LC 4062] applies if either the employee or employer objects to a medical determination made by the treating physician concerning any medical issues not covered by Section 4060 or 4061 and not subject to Section 4610.]

When can you request a panel?

A panel can be requested no earlier than the first working day that is at least 10 days after the date of mailing an objection to Labor code Section 4061 or 4062. The objection under Labor Code 4062 must be made within 20 days of receipt of the report.

How long does it take to strike from a panel?

Within 10 (ten) days of service of the panel, each party may strike one name from the panel. (2) Requests may be made twenty-four hours a day, seven days a week.

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