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REDESIGNATION OF PERSONAL PHYSICIAN In the event you sustain an injury or illness related to your employment, you may be treated for such injury or illness by your personal medical doctor (M.D.),

How to fill out predesignation of personal physician

How to fill out predesignation of personal physician

1. To fill out the predesignation of personal physician, follow these steps:
2. Obtain the predesignation form from your employer or insurance provider.
3. Fill in your personal information, such as your name, date of birth, and contact details.
4. Provide the name, address, and contact information of the physician you wish to designate as your personal physician.
5. Sign and date the form.
6. Submit the completed form to your employer or insurance provider as per their instructions.

Who needs predesignation of personal physician?

1. Predesignation of personal physician is needed by individuals who want to have control over their healthcare choices. It allows you to designate a specific physician as your primary care provider, who will coordinate your medical care and referrals. This can be beneficial if you have a preferred doctor or want to ensure continuity of care with a specific healthcare provider.

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What is predesignation of personal physician?

Predesignation of personal physician is the process of choosing a specific doctor or medical provider to be your primary caregiver in case of a work-related injury.

Who is required to file predesignation of personal physician?

Employees in California who have a workers' compensation insurance policy are required to file predesignation of personal physician.

How to fill out predesignation of personal physician?

To fill out predesignation of personal physician, employees need to complete a DWC Form 9783 and submit it to their employer's workers' compensation insurance carrier.

What is the purpose of predesignation of personal physician?

The purpose of predesignation of personal physician is to ensure that employees have access to medical care from a provider of their choice in case of a work-related injury.

What information must be reported on predesignation of personal physician?

The predesignation of personal physician form must include the employee's personal information, the name and contact information of the chosen physician, and the physician's agreement to provide treatment if needed.