REFERRAL
Settlement Walk-Through Checklist
We will prepare and submit your settlement document to the WCAB for a case number and obtain the Award/Order Approving once the case number is assigned.
- Signed Settlement Documents
- P&S report from PTP and/or PQME
- Benefit Printout showing TTD Paid
- Wage Statement (if TTD paid at less than maximum)
- First and Final TTD Benefit Notices
- Benefit Notice (showing we explained right to PQME)
- PQME Waiver (not necessary, but preferred if no PQME)
- Medical Report showing Release to RTW verifying final TTD
Independent Consultative Rating Checklist
Rating per the AMA Guidelines with a full analysis.
- P&S report from PTP and/or PQME
REFERRAL FORM
*required