GA WC-200a 2011 free printable template

WC-200a CHANGE OF PHYSICIAN / ADDITIONAL TREATMENT BY CONSENT GEORGIA STATE BOARD OF WORKERS COMPENSATION Instructions Prior to filing this form with the Board a Form WC-1 or WC-14 must have been previously filed with the Board.

How to fill out GA WC-200a

How to fill out GA WC-200a

1. Obtain the GA WC-200a form from the official website or local office.
2. Fill in your personal information in the designated fields including your name, address, and contact details.
3. Provide information regarding your employment history, including names of employers, job titles, and duration of employment.
4. Fill out the section regarding the reason for filing the claim, ensuring to include relevant details.
5. If applicable, attach any required documentation that supports your claim.
6. Review the form for accuracy and completeness before submission.
7. Submit the completed form by mailing it to the specified address or submitting it electronically if available.

Who needs GA WC-200a?

1. Individuals who are applying for workers' compensation benefits in the state of Georgia.
2. Employees who have been injured on the job and need to report their claims.
3. Workers seeking to claim benefits after a workplace-related illness or injury.

Instructions and Help about GA WC-200a

Hello there my name is Jason Perkins, and I'd like to welcome you to another episode in my Georgia workers compensation video series I'm an attorney that specializes in Georgia workers compensation cases and in my Georgia workers compensation video series I provide you with helpful information about the rules of Georgia's workers compensation law and the benefits available to you under that law today I'm going to talk to you about a form that's published by the state board workers compensation called a form WC — 200 it's used to basically designate your authorized treating physician or to designate other medical treatments if you're in — I'll turn your case and there's actually two different forms one is a form when you agree about medical treatment and the second is when there's a disagreement, and you're going to request certain medical treatment, but before we jump into that in detail be sure and be on the lookout for an upcoming episode in this series about the form WC rickety which is a form you used to request catastrophic designation your case now let's talk about the form WC — hundreds the form WC 20an an is the first form and this is the form that you use when both you and your employer or their insurance company agree to the medical treatment that's going to occur in your case this form can basically be used to designate a certain doctor as your authorized treating physician in other words you can change from one authorized treating position to another using this form, or it can be used to designate a doctor that's going to be an additional treating physician in your case in other words sometimes you would have a certain doctor be your authorized treating physician, but you would also need another specialist to treat you who's an additional treating physician, so you can do that through this form as well in this form is used when both parties agree about the doctor or the medical treatment that's going to be provided, so basically you provide the information on the form about what the medical treatment is going to be who the authorized doctor is going to be, and you file the form of the State Board of workers compensation, and it's there for reference later and essentially becomes an order of the state board at that point the second form the form WC that's 200 B is used when you do not agree about medical treatment is going to be provided so in other words when you want your doctor changed and the insurance company won't agree to the doctor that you think should be the authorized treating physician you may have to file a form WC 200 and B and request a change in treating physician you can specify the reasons that you're requesting on the form, and you can also attach documentation that supports those reasons that you've requested a change sometimes the insurance company will file the request to change doctors you may be treating with a doctor that you're happy with and the insurance company is not happy with that doctor because of the...

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What is GA WC-200a?

GA WC-200a is a form used in the state of Georgia for reporting workers' compensation information, specifically related to injuries or claims.

Who is required to file GA WC-200a?

Employers in Georgia who have employees that have sustained a work-related injury and need to report that claim are required to file GA WC-200a.

How to fill out GA WC-200a?

To fill out GA WC-200a, the employer needs to provide details about the injured employee, the nature of the injury, the date of the incident, and any medical treatment provided, among other necessary information.

What is the purpose of GA WC-200a?

The purpose of GA WC-200a is to formally document and report workers' compensation claims to the State Board of Workers' Compensation in Georgia.

What information must be reported on GA WC-200a?

The information that must be reported on GA WC-200a includes the employee's details, the date of injury, a description of the injury, any medical treatment details, and information about the employer.