9 hours ago Print Form STATE OF CALIFORNIA DOCTOR'S FIRST REPORT OF OCCUPATIONAL INJURY OR ILLNESS Reset Form Within 5 days of your initial examination, for every occupational injury or illness, send two copies of this report to the employer's workers' compensation insurance carrier or the insured employer. Failure to file a timely doctor's report may >> Go To The Portal
Print Form STATE OF CALIFORNIA DOCTOR'S FIRST REPORT OF OCCUPATIONAL INJURY OR ILLNESS Reset Form Within 5 days of your initial examination, for every occupational injury or illness, send two copies of this report to the employer's workers' compensation insurance carrier or the insured employer.
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.
Coming soon California EDI Implementation Guide for Doctor’s First Report of Occupational Illness or Injury. You may contact the DWC by email at dfr_edi@dir.ca.gov if you are interested in submitting DFRs using EDI.
Electronic Data Interchange (EDI) is the computer-to-computer exchange of data or information in a standardized format. In workers’ compensation, EDI refers to the electronic transmission of claims information from the treating physician to the DWC.
In order to bring greater efficiency to the workers’ compensation reporting, Senate Bill (SB) 1160 requires that the physician to electronically file the DFR with DWC. The new electronic system will allow for standardized data to be submitted directly to DWC and can be used to improve the workers’ compensation system.
What are the current processes — such as level of effort, timeline, and allowances — associated with filing WC-required reports in California?
There is a general consensus that the report should be required from the first physician who examines the patient following a work-related incident.
To reduce administrative burden, require a DFR only from the first primary treating physician and, if applicable, the first physician who examines the worker following a work-related incident who will not continue to treat the patient; combine the PR-2 and the RFA into a single form that clearly indicates when treatment authorization is being requested; eliminate the redundancies between the P&S report and the RTW and Voucher report; investigate whether to require electronic reporting for all WC-required reports and related documentation..