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Pursuant to Labor Code Sections 4061.5 and 139(e)(9), this form may be used by the treating physician primarily responsible for managing the care of the injured worker, or the physician designated by that physician, when rendering opinions on all medical issues necessary to determine eligibility for compensation. The Treating Physician's Determination of Medical Issues Form (Treating Physician's Form) is as follows:
NOTE: Sections 139, 4061 and 4061.5, Labor Code. Reference: Sections 139(e)(9), 4061 and 4061.5, Labor Code.
HISTORY
1. New section and forms filed 5-17-95; operative 5-24-95 pursuant to Government Code section 11343.4(d) (Register 95, No. 20).
Treating Physician's Determination of Medical Issues
Form (.pdf format, 20K)
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| The above information is provided free of charge by the Department of Industrial Relations from its web site at www.dir.ca.gov. |