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Clayton County Board of Commissioners WORKERS COMPENSATION MEDICAL AUTHORIZATION This will authorize visiting (check the applicable location): (Print Employees Name)Concentrate Medical Center Walking

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How to fill out workers compensation medical authorization

01

Gather all necessary documents such as the workers' compensation claim form and the medical authorization form.

02

Read through the workers' compensation medical authorization form carefully to understand the information it requires.

03

Fill out the personal information section of the authorization form, including your full name, address, contact number, and social security number.

04

Provide details about your employer, such as the company name, address, and contact information.

05

Include information about your medical condition, injury or illness for which you are seeking workers' compensation.

06

Specify the healthcare provider or medical facility you authorize to release your medical records to the workers' compensation insurance company.

07

Make sure to sign and date the authorization form in the designated area.

08

Review the completed form for accuracy and make any necessary corrections or additions.

09

Submit the filled-out workers' compensation medical authorization form to the appropriate party, such as your employer or the workers' compensation insurance provider.

10

Keep a copy of the authorization form for your records.

Who needs workers compensation medical authorization?

01

Employees who have suffered a work-related injury or illness and are seeking workers' compensation benefits.

02

Employers may also need workers' compensation medical authorization to process their employees' claims and access relevant medical records.

03

Medical professionals or healthcare providers involved in the workers' compensation process may require medical authorization to release a patient's medical records for insurance purposes.

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