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- Click ‘Get Form’ to open the PR-4 document in the editor.
- Begin by filling in the patient’s personal information, including their last name, first name, date of birth, and address. Ensure accuracy as this data is crucial for identification.
- Next, provide details about the claims administrator and employer. Include names, addresses, and phone numbers to facilitate communication regarding the claim.
- In the section for injury details, describe how the injury occurred and list any relevant medical history. This context is essential for evaluating permanent impairment.
- Complete the impairment rating section by reporting whole person impairment (WPI) ratings using the AMA Guides. Be sure to include tables and page numbers used for reference.
- Address pain assessment and apportionment by specifying any additional impairments due to pain and providing a narrative if necessary.
- Finally, review all sections for completeness before signing. Use our platform's features to save your progress or share it directly with relevant parties.
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