Doctor report 2025

1. Click ‘Get Form’ to open the doctor report in the editor.
2. Begin by filling out the 'Patient's Information' section. Enter the patient's name, date of birth, and contact details accurately.
3. Proceed to the 'Doctor's Information' section. Input your name, WCB Authorization number, and office address. Ensure all fields are completed for proper identification.
4. In the 'Billing Information' section, provide details about the employer's insurance carrier and any relevant diagnosis codes. This is crucial for processing claims efficiently.
5. Complete Section D regarding Maximum Medical Improvement (MMI). Indicate whether the patient has reached MMI and provide necessary dates or explanations as required.
6. Fill out Section E on Permanent Impairment/Work Status. Specify if there is a permanent impairment and complete either Schedule loss or Non-Schedule loss sections based on your assessment.
7. Finally, review Section F for Functional Capabilities/Exertional Abilities. Assess and document the patient's functional capacities accurately before signing off on the form.

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