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State of California Department of Industrial Relations Division of Workers\' Compensation FEE DISCLOSURE STATEMENT If you choose to be represented by an attorney, your attorney\'s fees will be deducted
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How to fill out californias new medical-legal fee

01
Download the new medical-legal fee form from the California state website.
02
Fill out the patient's information including name, address, and date of birth.
03
Provide details of the injury or medical condition the patient is seeking compensation for.
04
Include information on the medical treatment received and any relevant medical history.
05
Calculate and fill in the fees requested for the medical-legal evaluation and report.
06
Sign and date the form before submitting it to the appropriate parties.

Who needs californias new medical-legal fee?

01
Individuals in California who are seeking compensation for medical-legal evaluations and reports related to injuries or medical conditions.
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California's new medical-legal fee is a standardized fee schedule for services rendered by medical-legal consultants and examiners, aimed at controlling costs in the workers' compensation system.
Both medical providers who perform medical-legal evaluations and claims administrators who process these claims are required to file California's new medical-legal fee.
To fill out California's new medical-legal fee, you must complete the designated forms, providing accurate details regarding the services rendered, including dates, hours worked, and the specific fees charged, as per the guidelines set by the California Division of Workers' Compensation.
The purpose of California's new medical-legal fee is to create a transparent and equitable fee structure that ensures fairness in the compensation of medical-legal services within the workers' compensation system.
The information that must be reported includes the name of the provider, the services performed, dates of service, the hours spent on evaluations, and the corresponding fees, along with any relevant case information.
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