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1. Within five days but no more than 14 days from receipt of a medical treatment request by a treating physician, a utilization review determination should be made as to whether the request is authorized, delayed or rejected. If the determination is delayed, it's because additional information has been requested.
EMPLOYEE'S CLAIM FOR COMPENSATION/REPORT OF INITIAL TREATMENT. FORM C-4.
Compensation Rates An injured employee is entitled to a compensation rate equal to two-thirds of the average weekly wage (AWW) in New York State for the 52-week period immediately prior to the date of accident. The rate is subject to prescribed maximums and degree of disability.
The formula used by the New York State Workers' Compensation Board to calculate weekly settlement payments is as follows: Weekly Rate: 2/3 x average weekly wage x % of disability (for example, partial disability or temporary disability)
(t) "Request for authorization" 1 defines Request for Authorization as a written request for a specific course of proposed medical treatment. An RFA must meet both of the following criteria: Only for medical treatment and. Must be written.
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Accordingly, an employer's annual payroll, in $100 units, is multiplied by a price or \u201crate\u201d (which reflects the nature of the work) to determine the annual premium. This premium is modified, where appropriate, to reflect the individual employer's safety record.
Report of Termination of Disabilty. and/or Payment. U.S. Department of Labor. Form CA-3.
The New York State Workers' Compensation Law Judge sets the amount of the fee, which generally is between 10 and 15 percent of the award.
The problem that attorneys and injured workers face is that the evidence needed to determine whether the UR report is on time relies on a document that is difficult to obtain. The rule works this way; the treating doctor requests treatment by using a required form, the Request for Authorization (RFA).
Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee's treating physician to initiate the utilization review process required by Labor Code section 4610.

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