The California Audit Referral Form for Workers' Compensation is a document used to refer employers to the California Department of Insurance (CDI) for review of their Workers' Compensation insurance coverage. The CDI audits these policies to ensure employers are in compliance with Workers' Compensation laws. The referral form contains information about the employer, the policy, and the suspected violation of the Workers' Compensation laws. There are two types of California Audit Referral Forms for Workers' Compensation: the Initial Referral Form and the Follow-up Referral Form. The Initial Referral Form is used to make the initial referral to the CDI for review. This form is filled out by the employer and includes information about the policy, the employer, and the suspected violation. The Follow-up Referral Form is used to provide additional information or to update the CDI on the status of the policy. This form is also filled out by the employer and includes information about any changes to the policy or the employer's compliance with the Workers' Compensation laws.
California Audit Referral Form for Workers' Compensation
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How to fill out California Audit Referral Form For Workers' Compensation?
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FAQ
It depends on whether you tell your employer in writing?before you are injured?the name and address of your personal physician or a medical group. This is called ?predesignating.? If you predesignate, you may see your personal physician or the medical group right after you are injured.
Use the QME complaint form to file a complaint about a QME. Utilization review (UR) complaints: Medical providers, injured workers or others who find that UR is not being done ing to the regulations can file a complaint with the DWC. Use the UR complaint form to file a complaint about improper UR.
The Division of Workers' Compensation (DWC) monitors the administration of workers' compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers' compensation benefits.
Central Complaint Unit Toll-Free: 1-800-633-2322. Phone: (916) 263-2382. Fax: (916) 263-2435. Email: Complaint@mbc.ca.gov.
After your first medical examination, you may switch to another doctor in the HCO at least once. If you have health insurance through your employer, you may switch to a doctor outside the HCO 180 days after your illness or injury is reported to your employer.
Your DWC-1 claim form is your declaration that you have been injured while working, and that you believe you require compensation while you recover. A common misconception is that going to the doctor ? something you should doas soon as possible ? essentially creates a workers' comp claim for you.
Complaints may also be filed electronically with the Audit Unit at dwcauditunit@dir.ca.gov. Any complaint with more than five pages of supporting documentation should be submitted to the Audit Unit by mail. A copy of any complaint can also be sent to the claims administrator. Sometimes this helps to resolve a problem.