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Referal Forms
& Documents

We typically request the below claim file documents (if available) to create our file:

  • C-3 or C-4

  • Job Description

  • FCE Report

  • Perm Restricts/Final PR

  • Wage Calculation Form

  • PPD Rating or Date of PPD Evaluation

  • Name of Attorney (if rep’d)

  • IME Reports

  • Counselor Assignment letter

  • Claims Acceptance Letter

  • Initial Consultative Medical Report



Our referral forms can be downloaded if interested in using them.


For any questions email us at:

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