FORM 5021
Doctor's First Report of Occupational
Injury or Illness
FORM PR-2
Primary Treating Physician's Progress Report
FORM PR-3
Primary Treating Physician's Permanent &
Stationary Report
FORM DEU 102
Request for Summary Rating Determination
(of Primary Treating Physician's Report)
This form should be attached to Form PR-3.
FORM RU 90
Treating Physician's Report of Disability
FORM RU 91
Description of Job Duties
DWC FORM 280
Petition for Change of Primary Treating
Physician
IMC FORM 81556
Treating Physician's Determination
of Medical Issues
This is an optional form that can be used by a treating physician as a
supplemental report, at the completion of treatment, at discharge, or when a
worker becomes permanent and stationary.
