Wc164 form 2025

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4.3 out of 5

49 votes

The document is a standardized form from the Colorado Department of Labor and Employment for reporting worker's compensation injuries. It includes sections for case information, initial visit details, current work status, medical diagnosis, treatment plans, follow-up care, maximum medical improvement (MMI), and permanent medical impairment. The form must be completed by physicians and sent to both the injured worker and the insurer.

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Click ‘Get Form’ to open the wc164 form in the editor.
Begin by selecting the report type: Initial, Progress, or Closing. This sets the context for your report.
Fill in the Case Information section with details such as Date of Injury, Injured Worker’s Name, Social Security Number, and other relevant identifiers.
In the Initial Visit section, provide a description of the accident/injury as narrated by the injured worker and check if objective findings align with their history.
Update Current Work Status based on the injured worker's current condition and specify any Work Related Medical Diagnoses.
Complete the Plan of Care section by detailing treatment plans, work status, and any limitations or restrictions applicable to the injured worker.
Document Follow Up Care and Referrals including appointment dates and provider information if referrals are made.
Indicate Maximum Medical Improvement (MMI) status and whether maintenance care is required post-MMI.
Finally, provide details regarding Permanent Medical Impairment if applicable and ensure all physician information is accurately filled out at the end of the form.

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Versions	Form popularity	Fillable & printable
2019	4.6 Satisfied (31 Votes)
2014	4 Satisfied (60 Votes)
2006	4.3 Satisfied (49 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Why do I need a workers comp exemption?

Most states require businesses with employees to carry workers compensation insurance. But you may be able to apply for a workers comp exemption for certain types of workers, like independent contractors. This means you dont have to provide workers comp to cover that worker if they get hurt or sick from their job.

What not to say to a workmans comp doctor?

Avoid Downplaying Your Injury: Dont minimize your pain or discomfort. Statements such as Its not that bad or Im sure Ill be fine can lead to your injury being categorized as less severe than it actually is. Dont Speculate on Recovery Time: Do not make guesses about how quickly you will recover.

How to deal with workers comp doctors?

When talking to your doctor, be thorough, but be honest. To get the proper treatment and physical therapy you need, try your best to explain your pain and limitations in a practical way by providing examples and describing your work-related injury as accurately as possible.

What to say and not to say at a disability doctor?

To best support your SSDI or SSI claim, you should never: Say You Are Okay. Do not tell the doctor you are okay, fine, or pretty good when you are there for an assessment of your condition. Tell Them You Are Not in Pain. Downplay Your Condition. Exaggerate Your Symptoms or Disabilities. Give Your Opinion.

What not to say to Workmans Comp?

What Not to Say to a Workers Comp Doctor Avoid Downplaying Your Injury: Dont minimize your pain or discomfort. Dont Speculate on Recovery Time: Do not make guesses about how quickly you will recover. Stay Away from Absolute Statements: Do not use words like always or never when describing your symptoms.

How to get the most out of a workers comp settlement?

Seven ways to obtain the best workers compensation settlement possible include: Letting your employer know you were injured. Getting medical care as soon as possible. Filing your workers comp claim. Understanding how disability rating works. Never trusting or providing a recorded statement to the insurance company.

What information is needed to file a workers compensation claim?

This will include your full name, address, phone number, and social security number. You will also need to provide your employers name and address, as well as the date of your injury or illness. In addition to your personal information, you will also need to provide information about your injury or illness.

Wc164 form 2025

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