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CLEAN COPY DWC Form RFA - California Department of ...
www.dir.ca.govDWC Form RFA (Effective 2/2014) Page 2 Instructions for Request for Authorization Form Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee’s treating physician to initiate the utilization review process required by Labor Code section 4610.
State of California, Division of Workers’ Compensation …
www.dir.ca.govRequested Treatment (see instructions for guidance; attached additional pages if necessary) ... Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employee’s treating physician to initiate the utilization review process required by Labor Code section 4610. A Doctor’s First Report of