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The document outlines the Request for Authorization for Medical Treatment (DWC Form RFA) used in California's workers' compensation system. It details the necessary information required from patients, claims administrators, and providers to initiate the utilization review process for medical treatment requests. The form includes sections for patient and provider information, requested treatments, and guidelines for expedited reviews. It emphasizes the importance of timely responses from claims administrators and provides instructions on how to properly complete the form.

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2014	4.9 Satisfied (312 Votes)
2012	4.2 Satisfied (72 Votes)

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What RFA 2?

The RFA-2 is a New York State Workers' Compensation Board form. Specifically, it is a \u201cRequest For Further Action\u201d by the carrier or employer and can be found here. This form would be filed by the carrier or employer when a need for a hearing arises.

What is a 5021 form?

Every physician who treats an injured employee must file a complete Form 5021 Doctor's First Report of Occupational Illness or Injury (DFR) with the employer's claims administrator within five days of the initial examination.

What is an RFA authorization?

An RFA is a form that the doctor is required to use to request treatment, diagnostic tests or other medical services for an injured worker. If the treatment request was first made verbally, it must be confirmed in writing.

How long is utilization review Authorization good for?

If there is a utilization review denial of treatment, an injured worker can appeal the denial of workers comp benefits. Absent a change in circumstances, a utilization review denial is valid for twelve months.

What does RFA mean in workers comp?

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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What is an RFA form?

What is a RFA report?

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).

What does request for Authorization mean?

(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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