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- Click ‘Get Form’ to open the DWC 73 in the editor.
- Begin by filling in the 'General Information' section. Enter the date sent, your name, date of injury, and social security number (last four digits). Ensure you provide accurate details about your injury and employer's information.
- In the 'Work Status Information' section, select the appropriate box regarding your medical condition. Specify if you can return to work without restrictions, with restrictions, or if you are unable to return. Fill in estimated dates as necessary.
- If applicable, complete the 'Activity Restrictions' section by detailing any limitations on posture, motion, lifting/carrying, and other specific restrictions related to your condition.
- Finally, provide treatment and follow-up appointment information. Include diagnosis details and expected follow-up services. Don’t forget to sign the form before submission.
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