Get the free blank dwc 25 form florida

FORM DFS-F5-DWC-25 COMPLETION/SUBMISSION INSTRUCTIONS GENERAL INFORMATION The Form DFS-F5-DWC-25 has been adopted by the Florida Division of Workers' Compensation in Rule 69L-7.602, F.A.C., as the

001, 440.003, and 440.058, F.A.C. The forms are available free of charge by calling the Division of Workers' Compensation (). All reports must state the name of the patient as well as the date, nature and treatment of the injuries/disabilities. They must also reflect if there have been any changes to the patient's treatment, hospitalization, rehabilitation or follow-up plans and/or a reduction of the original disability rating. The Florida Division of Workers' Compensation has been authorized by the Florida Legislature to adopt rules and regulations establishing criteria for the assignment of certain disability classification, impairment ratings, restoration dates and other disability classifications for employees subject to workers' compensation. The Division of Workers' Compensation also has the authority to establish permanent impairment ratings, for which there is a specific restoration date. An impairment class assigned by the workers' compensation system is valid for no less than two years from the date of its establishment or from the date the permanent rating is determined, whichever occurs first. The Division of Workers Compensation is authorized to establish the restoration dates for employees who have been classified permanently as disabled through the use of a permanent impairment rating or as restored from a temporary impairment rating when the person has had continuous medical improvement from that rating. A person shall not be required to submit a response on any work item until the Division of Workers' Compensation has determined all the items have been performed and the person has been classified permanently as disabled through the use of a permanent impairment rating or was restored from a temporary impairment rating when the person has had continuous medical improvement from that rating. The Division of Workers' Compensation retains the final authority to determine whether an employee and a physician agree, in writing, to the assignment of a permanent impairment rating or subsequent restoration date. The medical reports prepared by physicians of patients undergoing temporary disability examinations do the same thing. The original medical records for these evaluations must be retained by the physician when the examination has been completed. It is the duty of all physicians to ensure that the medical records are retained and filed for the period of the examination and the duration of the disability rating and for at least two years thereafter and for the duration of the permanent impairment rating. After the person's permanent rating is established, the physician must file a written statement of his or her reasons for the permanent impairment rating and/or the restoration of the temporary rating, as applicable.

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