2006年6月25日 · The provider must complete form DFS-F5-DWC-25 to request authorization for a medical treatment plan, to communicate to the carrier an injured employee’s medical status, to …

LEVEL I - Key issue: specific, well-defined medical condition, with clear correlation between objective relevant physical findings and patients' subjective complaints.

Form DFS-F5-DWC-25 (revised 5-26-05) Page 2 of 2

Florida Workers' Compensation Uniform Medical Treatment/Status Reporting Form - PAGE 2 ... Assignment of limitations or restrictions must be based upon the injured employee's specific …

A DWC 25 form is a state regulatory document used by the medical provider to inform about the medical evaluation, work status, treatment plan, and precautions for the injured worker. It is …

GENERAL INFORMATION The Form DFS-F5-DWC-25 has been adopted by the Florida Division of Workers’ Compensation in Rule 69L-7.602, F.A.C., as the required reporting form for …

LEVEL I - Key issue: specific, well-defined medical condition, with clear correlation between objective relevant physical findings and patients' subjective complaints. Treatment correlates …

2015年1月1日 · Physicians completing the Form DFS-F5-DWC-25 must apply the following guidelines: • Accurate completion and submission of the Form DFS-F5-DWC-25 does not fulfill …